Healthcare Provider Details

I. General information

NPI: 1023957909
Provider Name (Legal Business Name): NIKA L SESSIONREED DRIVER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2026
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3416 S NEWTON AVE
SPRINGFIELD MO
65807-4330
US

IV. Provider business mailing address

3416 S NEWTON AVE
SPRINGFIELD MO
65807-4330
US

V. Phone/Fax

Practice location:
  • Phone: 904-534-1289
  • Fax:
Mailing address:
  • Phone: 904-534-1289
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: