Healthcare Provider Details

I. General information

NPI: 1669583761
Provider Name (Legal Business Name): NIKKI M. MIGLORE DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NIKKI M. SIMONSON DC

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5533 E BELL RD SUITE 109
SCOTTSDALE AZ
85254-1228
US

IV. Provider business mailing address

5533 E BELL RD SUITE 109
SCOTTSDALE AZ
85254-1228
US

V. Phone/Fax

Practice location:
  • Phone: 602-788-4200
  • Fax: 602-788-4208
Mailing address:
  • Phone: 602-788-4200
  • Fax: 602-788-4208

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number7213
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number3902
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: