Healthcare Provider Details

I. General information

NPI: 1699116988
Provider Name (Legal Business Name): NIKKI'S LITTLE HELPING HAND
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2013
Last Update Date: 07/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 CORONET LN APT 505
JACKSONVILLE FL
32207-5176
US

IV. Provider business mailing address

2900 CORONET LN APT 505
JACKSONVILLE FL
32207-5176
US

V. Phone/Fax

Practice location:
  • Phone: 904-438-0605
  • Fax: 904-619-8730
Mailing address:
  • Phone: 904-438-0605
  • Fax: 904-619-8730

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: SHAWNATA NICOLE MARSHALL
Title or Position: OWNER
Credential:
Phone: 904-438-0605