Provider Demographics
NPI:1073306700
Name:NIGGEMAN, DEBRA LEIGH
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:LEIGH
Last Name:NIGGEMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:675 TIMBER LN
Mailing Address - Street 2:
Mailing Address - City:DEVON
Mailing Address - State:PA
Mailing Address - Zip Code:19333-1248
Mailing Address - Country:US
Mailing Address - Phone:610-304-1581
Mailing Address - Fax:
Practice Address - Street 1:825 W LANCASTER AVE
Practice Address - Street 2:
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-3337
Practice Address - Country:US
Practice Address - Phone:610-304-1581
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-26
Last Update Date:2025-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN007963133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist