Provider Demographics
NPI:1053585174
Name:NIENABER, BRENT JEFFREY (CNIM)
Entity type:Individual
Prefix:
First Name:BRENT
Middle Name:JEFFREY
Last Name:NIENABER
Suffix:
Gender:M
Credentials:CNIM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6669 MORRISON DR STE 360
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80221-2660
Mailing Address - Country:US
Mailing Address - Phone:303-339-1499
Mailing Address - Fax:
Practice Address - Street 1:6669 MORRISON DR
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80221
Practice Address - Country:US
Practice Address - Phone:303-803-4004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-18
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic