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Contact Information

MARK NIENHUIS, PA
#10 PUEBLO PINTADO SCHOOL
CUBA, NM87013
 Phone: 505-786-5291
 Fax: 505-786-6440
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for MARK NIENHUIS · (Male)

NPI # 1417987868
Status Active
Credentials PA (Physician Assistant)
Entity Individual
Enumeration date 07/03/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • OH License # 50001806
  • NM Medicaid 97702242
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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