Provider Demographics
NPI:1508137878
Name:LOBELLO, NIKKI (LPN)
Entity Type:Individual
Prefix:
First Name:NIKKI
Middle Name:
Last Name:LOBELLO
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:808 ERIE STATION RD
Mailing Address - Street 2:
Mailing Address - City:RUSH
Mailing Address - State:NY
Mailing Address - Zip Code:14543-9734
Mailing Address - Country:US
Mailing Address - Phone:585-857-1470
Mailing Address - Fax:
Practice Address - Street 1:808 ERIE STATION RD
Practice Address - Street 2:
Practice Address - City:RUSH
Practice Address - State:NY
Practice Address - Zip Code:14543-9734
Practice Address - Country:US
Practice Address - Phone:585-857-1470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-19
Last Update Date:2012-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7603218164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse