Healthcare Provider Details

I. General information

NPI: 1669767711
Provider Name (Legal Business Name): MRS. NIKIA BURTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: NIKIA RUCKER

II. Dates (important events)

Enumeration Date: 06/16/2011
Last Update Date: 01/16/2024
Certification Date: 01/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8640 BALBOA DR
CINCINNATI OH
45231-4527
US

IV. Provider business mailing address

8640 BALBOA DR
CINCINNATI OH
45231-4527
US

V. Phone/Fax

Practice location:
  • Phone: 513-284-0166
  • Fax:
Mailing address:
  • Phone: 513-284-0166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: