Provider Demographics
NPI:1205684149
Name:HASTINGS, JODI NIKITA (MD)
Entity type:Individual
Prefix:DR
First Name:JODI
Middle Name:NIKITA
Last Name:HASTINGS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7005 NW 67TH TER
Mailing Address - Street 2:
Mailing Address - City:PARKLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33067-4734
Mailing Address - Country:US
Mailing Address - Phone:954-821-1931
Mailing Address - Fax:
Practice Address - Street 1:ASCENSION PROVIDENCE ROCHESTER HOSPITAL
Practice Address - Street 2:1101 W UNIVERSITY DRIVE
Practice Address - City:ROCHESTER
Practice Address - State:MI
Practice Address - Zip Code:48307
Practice Address - Country:US
Practice Address - Phone:248-652-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-07
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty