Healthcare Provider Details

I. General information

NPI: 1497385926
Provider Name (Legal Business Name): NIKKI THERESE PLASKETT RN. IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2020
Last Update Date: 01/23/2020
Certification Date: 01/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5931 4TH ST NW
WASHINGTON DC
20011-2132
US

IV. Provider business mailing address

5931 4TH ST NW
WASHINGTON DC
20011-2132
US

V. Phone/Fax

Practice location:
  • Phone: 202-246-7314
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberRN1040349
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: