Provider Demographics
NPI:1326820135
Name:EVANS, NIKKI POKIPALA (SLP)
Entity Type:Individual
Prefix:
First Name:NIKKI
Middle Name:POKIPALA
Last Name:EVANS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:NIKKI
Other - Middle Name:ELAINE
Other - Last Name:POKIPALA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:2944 E 76TH PL
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-8721
Mailing Address - Country:US
Mailing Address - Phone:562-833-4845
Mailing Address - Fax:
Practice Address - Street 1:240 S ADAMS ST
Practice Address - Street 2:
Practice Address - City:JENKS
Practice Address - State:OK
Practice Address - Zip Code:74037-2573
Practice Address - Country:US
Practice Address - Phone:918-409-0157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-17
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK6095235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist