Individual provider · NPI-1
Deborah R Niesen, RN
Registered Nurse, Pediatrics · Racine, WI
NPI number1750698650
StatusActive
Last updated in NPPESSep 16, 2010
Details
- NPI
- 1750698650
- Entity type
- Individual (NPI-1)
- Name
- Deborah R Niesen
- Credential
- RN
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Sep 13, 2010
- Last updated
- Sep 16, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163WP0200X | Registered Nurse, Pediatrics | 90285-30 | WI | Yes |
| 163WG0000X | Registered Nurse, General Practice | 90285-30 | WI | |
| 163WC0400X | Registered Nurse, Case Management | 90285-30 | WI | |
| 163W00000X | Registered Nurse | 90285-30 | WI |
Practice location
2525 Amys BndRacine, WI 53402-5505
Phone 262-498-2993
Mailing address
2525 Amys BndRacine, WI 53402-5505
Phone 262-498-2993
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