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General NPI Number Information
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NPI Number | 1932857695
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Entity Type | Individual
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Provider Name | XOLISA BUHLE NIKANI
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Gender | Female
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Dates
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Enumeration Date | 03/12/2022
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Last Update Date | 03/12/2022
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Provider Practice Location Address
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Address Line | 1511 E 9TH ST
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City | DES MOINES
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State | IA
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Zip | 50316-2205
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Country | US
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Telephone | 515-528-1027
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Fax | 515-646-5310
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Provider Business Mailing Address
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Address Line | 1511 E 9TH ST
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City | DES MOINES
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State | IA
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Zip | 50316-2205
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Country | US
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Telephone | 515-528-1027
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Fax | 515-646-5310
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number | 180035
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License Number State | IA
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