Provider Demographics
NPI:1851605182
Name:NIES, PAUL M (MS)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:M
Last Name:NIES
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4512 RACCOON TRL
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37076-4701
Mailing Address - Country:US
Mailing Address - Phone:814-323-1488
Mailing Address - Fax:
Practice Address - Street 1:230 VENTURE CIR
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37228-1604
Practice Address - Country:US
Practice Address - Phone:615-291-6414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-28
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health