Healthcare Provider Details

I. General information

NPI: 1891480216
Provider Name (Legal Business Name): NIKKITA GERAK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: NIKKITA ELMINOWSKI

II. Dates (important events)

Enumeration Date: 04/11/2023
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1505 SW CARY PKWY STE 200
CARY NC
27511-6219
US

IV. Provider business mailing address

147 WALTONS CREEK RD
MORRISVILLE NC
27560-8737
US

V. Phone/Fax

Practice location:
  • Phone: 919-303-6890
  • Fax:
Mailing address:
  • Phone: 704-219-6409
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number59.00093
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: