Provider Demographics
NPI:1023840550
Name:BURLEY, NIKIA LYNETTE
Entity type:Individual
Prefix:
First Name:NIKIA
Middle Name:LYNETTE
Last Name:BURLEY
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 1:4617 DEER CREEK CT APT 8
Mailing Address - Street 2:
Mailing Address - City:AUSTINTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44515-5443
Mailing Address - Country:US
Mailing Address - Phone:614-743-6191
Mailing Address - Fax:
Practice Address - Street 1:4617 DEER CREEK CT APT 8
Practice Address - Street 2:
Practice Address - City:AUSTINTOWN
Practice Address - State:OH
Practice Address - Zip Code:44515-5443
Practice Address - Country:US
Practice Address - Phone:614-743-6191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-14
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251E00000X, 385H00000X, 374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No251E00000XAgenciesHome Health
No385H00000XRespite Care FacilityRespite Care