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General NPI Number Information
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NPI Number | 1760005995
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Entity Type | Organization
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Legal Business Name | DR. NIKKI NP LLC
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Dates
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Enumeration Date | 05/21/2020
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Last Update Date | 03/29/2021
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Provider Practice Location Address
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Address Line | 1070 W HORIZON RIDGE PKWY STE 111
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City | HENDERSON
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State | NV
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Zip | 89012-6019
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Country | US
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Telephone | 702-336-0843
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Fax | 469-242-9677
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Provider Business Mailing Address
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Address Line | 1070 W HORIZON RIDGE PKWY STE 111
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City | HENDERSON
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State | NV
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Zip | 89012-6019
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Country | US
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Telephone | 702-336-0843
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Fax | 469-242-9677
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Authorized Official
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Title or Position | NURSE PRACTITIONER/CEO
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Name | DR. NIKESHA MOBLEY
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Credential | DNP, APRN-CNP
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Telephone | 702-336-0843
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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