Healthcare Provider Details

I. General information

NPI: 1174432876
Provider Name (Legal Business Name): NIKKI LASHON MARTIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6003 VETERANS PKWY STE 225
COLUMBUS GA
31909-6288
US

IV. Provider business mailing address

6003 VETERANS PKWY STE 225
COLUMBUS GA
31909-6288
US

V. Phone/Fax

Practice location:
  • Phone: 706-332-5912
  • Fax: 855-663-5686
Mailing address:
  • Phone: 706-332-5912
  • Fax: 855-663-5686

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: