Provider Demographics
NPI:1225798390
Name:THOMPSON, NIKEYA RAYCHELLE
Entity Type:Individual
Prefix:
First Name:NIKEYA
Middle Name:RAYCHELLE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1434 MILBURN LANDING CIR
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-5997
Mailing Address - Country:US
Mailing Address - Phone:910-273-4915
Mailing Address - Fax:
Practice Address - Street 1:1000 FORESTVILLE RD STE 108
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-9348
Practice Address - Country:US
Practice Address - Phone:919-769-6690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-30
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5368111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor