Asa Marie Niedbalski, AGNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

71011321A Issued in IN

Practice address

1597 Cold Springs Dr
Pendleton, IN 46064-5506

Phone

(574) 274-2560

Fax

(317) 219-0879

NPI assigned

Jul 15, 2021

Last updated

May 16, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1626307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715817600000",
    "number": "1376115535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1597 COLD SPRINGS DR",
            "city": "PENDLETON",
            "state": "IN",
            "postal_code": "460645506",
            "telephone_number": "574-274-2560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1597 COLD SPRINGS DR",
            "city": "PENDLETON",
            "state": "IN",
            "postal_code": "460645506",
            "telephone_number": "574-274-2560",
            "fax_number": "317-219-0879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEDBALSKI",
        "first_name": "ASA",
        "middle_name": "MARIE",
        "credential": "AGNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-15",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IN",
            "license": "71011321A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Elizabeth Musgrave, DO
• Patrick Mwonya
• Jennifer A Neise, DDS
• Kayla E Newby, N.P.
• Scott Newkirk, MD
• Lucky Nomugisha
• Whitney Owens
• Deepkumar Patel, DDS, MPH
• Nirav Patel
• Pendleton Counseling Services

• Gerontology Nurse Practitioner in Pendleton, IN
• Providers in Pendleton, IN by specialty
• Gerontology Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.