Provider Demographics
NPI:1184906950
Name:OUIMETTE, NIKI ANN (LPN)
Entity type:Individual
Prefix:MRS
First Name:NIKI
Middle Name:ANN
Last Name:OUIMETTE
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 1:29 FRAZEE ST
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:NY
Mailing Address - Zip Code:13021-2251
Mailing Address - Country:US
Mailing Address - Phone:315-253-3580
Mailing Address - Fax:315-253-3580
Practice Address - Street 1:29 FRAZEE ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:NY
Practice Address - Zip Code:13021-2251
Practice Address - Country:US
Practice Address - Phone:315-253-3580
Practice Address - Fax:315-253-3580
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-16
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1394331164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse