Provider Demographics
NPI:1134408032
Name:ECTOR, NIKKI JOY
Entity type:Individual
Prefix:
First Name:NIKKI
Middle Name:JOY
Last Name:ECTOR
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 1:8620 S EASTERN AVE
Mailing Address - Street 2:#16
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-2836
Mailing Address - Country:US
Mailing Address - Phone:702-992-0576
Mailing Address - Fax:702-992-0391
Practice Address - Street 1:3121 WARM SPRINGS RD.
Practice Address - Street 2:#1102
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014
Practice Address - Country:US
Practice Address - Phone:702-992-0576
Practice Address - Fax:702-992-0391
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-09
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency