Provider Demographics
NPI:1457947640
Name:NIEMYER, KRISTIN ELISE (NP)
Entity Type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:ELISE
Last Name:NIEMYER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MISS
Other - First Name:KRISTIN
Other - Middle Name:ELISE
Other - Last Name:CULBRETH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:500 LAUCHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LAURINBURG
Mailing Address - State:NC
Mailing Address - Zip Code:28352-5501
Mailing Address - Country:US
Mailing Address - Phone:910-291-7630
Mailing Address - Fax:
Practice Address - Street 1:500 LAUCHWOOD DR
Practice Address - Street 2:
Practice Address - City:LAURINBURG
Practice Address - State:NC
Practice Address - Zip Code:28352-5501
Practice Address - Country:US
Practice Address - Phone:910-291-7630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-12
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2000239473363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care