Provider Demographics
NPI:1578344487
Name:YOUNG, NIKIYA A (RN)
Entity Type:Individual
Prefix:
First Name:NIKIYA
Middle Name:A
Last Name:YOUNG
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:NIKKI
Other - Middle Name:
Other - Last Name:YOUNG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:6588 OCTAVE AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89139-6747
Mailing Address - Country:US
Mailing Address - Phone:702-625-1890
Mailing Address - Fax:
Practice Address - Street 1:6588 OCTAVE AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89139-6747
Practice Address - Country:US
Practice Address - Phone:702-625-1890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-09
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95059140174H00000X
NVRN90849174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator