Healthcare Provider Details

I. General information

NPI: 1306759998
Provider Name (Legal Business Name): NIKIWITHBUNDLES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

206 E 86TH PL
MERRILLVILLE IN
46410-6258
US

IV. Provider business mailing address

3068 MALLORY ST
PORTAGE IN
46368-7507
US

V. Phone/Fax

Practice location:
  • Phone: 219-203-8707
  • Fax:
Mailing address:
  • Phone: 219-331-3517
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: NIKIYA HEARNS
Title or Position: CEO
Credential:
Phone: 219-331-3517