MEDICARE: NIKKI ROMERO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164W00000X	Licensed Practical Nurse	4703127749	MI

General Provider Information

NPI Number	:	1407631294
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NIKKI ROMERO

Provider Business Mailing Address
First Line	:	239 E GRAND RIVER RD APT 2
Second Line	:
City	:	LAINGSBURG
State	:	MI
Zip	:	48848-8601
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	239 E GRAND RIVER RD APT 2
Second Line	:
City	:	LAINGSBURG
State	:	MI
Zip	:	48848-8601
Country	:	US
Telephone Number	:	615-926-1679
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2023
Last Update Date	:	08/29/2023

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Directions to “ NIKKI ROMERO ” Practice Location

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