Provider Demographics
NPI:1902144744
Name:NIEBEL, KATHRYN ANN (ATC RN)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:ANN
Last Name:NIEBEL
Suffix:
Gender:F
Credentials:ATC RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:702 MOONSTONE DR
Mailing Address - Street 2:
Mailing Address - City:ALLISON PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15101-4236
Mailing Address - Country:US
Mailing Address - Phone:412-486-4927
Mailing Address - Fax:
Practice Address - Street 1:702 MOONSTONE DR
Practice Address - Street 2:
Practice Address - City:ALLISON PARK
Practice Address - State:PA
Practice Address - Zip Code:15101-4236
Practice Address - Country:US
Practice Address - Phone:412-486-4927
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-29
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN748616163W00000X
PA2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No163W00000XNursing Service ProvidersRegistered Nurse