Provider Demographics
NPI:1124779343
Name:NIEHAUS, NICHOLAS M
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:M
Last Name:NIEHAUS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:468 DEBONHILL CT
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45238-5218
Mailing Address - Country:US
Mailing Address - Phone:513-574-6273
Mailing Address - Fax:
Practice Address - Street 1:468 DEBONHILL CT
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45238-5218
Practice Address - Country:US
Practice Address - Phone:513-574-6273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-11
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care