Provider Demographics
NPI:1952986218
Name:NIESE, KIRSTEN MARIE (PHARMD)
Entity Type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:MARIE
Last Name:NIESE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4750 E GALBRAITH RD STE 104
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-6706
Mailing Address - Country:US
Mailing Address - Phone:513-686-5183
Mailing Address - Fax:513-686-5901
Practice Address - Street 1:4750 E GALBRAITH RD STE 104
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-6706
Practice Address - Country:US
Practice Address - Phone:513-686-5183
Practice Address - Fax:513-686-5901
Is Sole Proprietor?:No
Enumeration Date:2021-03-17
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH032329231835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care