Provider Demographics
NPI:1326644626
Name:SIMONSEN, NIKOLAI (DC)
Entity Type:Individual
Prefix:DR
First Name:NIKOLAI
Middle Name:
Last Name:SIMONSEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8837 SIX FORKS RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-2970
Mailing Address - Country:US
Mailing Address - Phone:919-827-0303
Mailing Address - Fax:919-827-8057
Practice Address - Street 1:8837 SIX FORKS RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-2970
Practice Address - Country:US
Practice Address - Phone:919-827-0303
Practice Address - Fax:919-827-8057
Is Sole Proprietor?:No
Enumeration Date:2020-12-10
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5240111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor