Provider Demographics
NPI:1306433081
Name:CHRISTOPHER, NIKKI MARION (RN)
Entity type:Individual
Prefix:
First Name:NIKKI
Middle Name:MARION
Last Name:CHRISTOPHER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2409 HALLS VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:TRION
Mailing Address - State:GA
Mailing Address - Zip Code:30753-5264
Mailing Address - Country:US
Mailing Address - Phone:423-972-9240
Mailing Address - Fax:
Practice Address - Street 1:2409 HALLS VALLEY DR
Practice Address - Street 2:
Practice Address - City:TRION
Practice Address - State:GA
Practice Address - Zip Code:30753-5264
Practice Address - Country:US
Practice Address - Phone:423-972-9240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-28
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN267909163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
GARN267909OtherNURSING LICENSE