Provider Demographics
NPI:1659694339
Name:JAMES, NIKKI LYNN
Entity Type:Individual
Prefix:MRS
First Name:NIKKI
Middle Name:LYNN
Last Name:JAMES
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 1:1276 UPPER FRONT ST
Mailing Address - Street 2:
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13901-1011
Mailing Address - Country:US
Mailing Address - Phone:607-722-0354
Mailing Address - Fax:607-722-6883
Practice Address - Street 1:1276 UPPER FRONT ST
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13901-1011
Practice Address - Country:US
Practice Address - Phone:607-722-0354
Practice Address - Fax:607-722-6883
Is Sole Proprietor?:No
Enumeration Date:2010-03-09
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY046203-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist