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General NPI Number Information
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NPI Number | 1730064262
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Entity Type | Organization
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Legal Business Name | OPTIMIZE WITH DR. NIKKI
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Dates
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Enumeration Date | 08/05/2025
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Last Update Date | 08/05/2025
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Provider Practice Location Address
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Address Line | 594 HIGHWAY 100
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City | CENTERVILLE
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State | TN
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Zip | 37033-1212
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Country | US
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Telephone | 615-586-0662
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Fax | 949-864-3356
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Provider Business Mailing Address
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Address Line | 594 HIGHWAY 100
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City | CENTERVILLE
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State | TN
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Zip | 37033-1212
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Country | US
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Telephone | 615-586-0662
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Fax | 949-864-3356
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Authorized Official
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Title or Position | OWNER/FAMILY NURSE PRACTITIONER
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Name | NICOLETTE STEPHENS
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Credential | DNP, FNP-C
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Telephone | 615-586-0662
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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