Provider Demographics
NPI:1346039419
Name:NIKKI WHOLE HEALTH LLC
Entity type:Organization
Organization Name:NIKKI WHOLE HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:BONDURIS
Authorized Official - Last Name:WALDEN
Authorized Official - Suffix:
Authorized Official - Credentials:CNS, LDN, LMT
Authorized Official - Phone:940-368-2328
Mailing Address - Street 1:21214 MALIBU COLONY
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78259-2009
Mailing Address - Country:US
Mailing Address - Phone:210-960-2653
Mailing Address - Fax:210-492-0747
Practice Address - Street 1:21214 MALIBU COLONY
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78259-2009
Practice Address - Country:US
Practice Address - Phone:210-960-2653
Practice Address - Fax:210-492-0747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Multi-Specialty