Provider Demographics
NPI:1609421346
Name:NIES, KATHLEEN BRIGID
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:BRIGID
Last Name:NIES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6032 DEERFIELD DR
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW
Mailing Address - State:PA
Mailing Address - Zip Code:16415-3222
Mailing Address - Country:US
Mailing Address - Phone:724-766-4711
Mailing Address - Fax:
Practice Address - Street 1:6032 DEERFIELD DR
Practice Address - Street 2:
Practice Address - City:FAIRVIEW
Practice Address - State:PA
Practice Address - Zip Code:16415-3222
Practice Address - Country:US
Practice Address - Phone:724-766-4711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-08
Last Update Date:2019-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist