Provider Demographics
NPI:1699529651
Name:ALIFF, NIKI (AGACNP)
Entity type:Individual
Prefix:
First Name:NIKI
Middle Name:
Last Name:ALIFF
Suffix:
Gender:F
Credentials:AGACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3036 OLD COUNTY RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGROSE
Mailing Address - State:WV
Mailing Address - Zip Code:25024-9651
Mailing Address - Country:US
Mailing Address - Phone:304-961-0460
Mailing Address - Fax:
Practice Address - Street 1:4605 MACCORKLE AVE SW
Practice Address - Street 2:
Practice Address - City:SOUTH CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25309-1311
Practice Address - Country:US
Practice Address - Phone:304-961-0460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-16
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV105276363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care