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NPI Code Detail

MEDICARE: MS. PAULA ANN NIEDERBAUMER NP

MEDICARE: MS. PAULA ANN NIEDERBAUMER NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner154638OH

General Provider Information

NPI Number : 1124295712
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. PAULA ANN NIEDERBAUMER NP
Provider Business Mailing Address
First Line : 375 DIXMYTH AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45220-2475
Country : US
Telephone Number : 513-872-1414
Fax Number : 513-872-4980
Provider Business Practice Location Address
First Line : 375 DIXMYTH AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45220-2489
Country : US
Telephone Number : 513-872-1414
Fax Number : 513-872-4980
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/13/2008
Last Update Date : 05/13/2008

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