Healthcare Provider Details

I. General information

NPI: 1023606944
Provider Name (Legal Business Name): ANITRA MARIE NIECE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2021
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3654 WERK RD
CINCINNATI OH
45248-4900
US

IV. Provider business mailing address

10864 PIPPIN RD
CINCINNATI OH
45231-1546
US

V. Phone/Fax

Practice location:
  • Phone: 513-452-0929
  • Fax: 513-540-4909
Mailing address:
  • Phone: 513-307-5798
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number346788
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4038591
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number28231560A
License Number StateIN
# 4
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0029085
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: