Provider Demographics
NPI:1275916470
Name:PEOPLES, NIKKI NICOLE
Entity Type:Individual
Prefix:
First Name:NIKKI
Middle Name:NICOLE
Last Name:PEOPLES
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 1:10406 JACKSON OAKS WAY STE A
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-3338
Mailing Address - Country:US
Mailing Address - Phone:865-771-6783
Mailing Address - Fax:
Practice Address - Street 1:10406 JACKSON OAKS WAY STE A
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922
Practice Address - Country:US
Practice Address - Phone:865-771-6783
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-07
Last Update Date:2019-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA251171100000X
TN309171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist