Provider Demographics
NPI:1255052924
Name:MONEYMAKER, NIKKI MARIE (PHLEBOTOMIST)
Entity type:Individual
Prefix:MS
First Name:NIKKI
Middle Name:MARIE
Last Name:MONEYMAKER
Suffix:
Gender:F
Credentials:PHLEBOTOMIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3831 S EWING ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46237-1258
Mailing Address - Country:US
Mailing Address - Phone:317-514-2095
Mailing Address - Fax:
Practice Address - Street 1:3831 S EWING ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46237-1258
Practice Address - Country:US
Practice Address - Phone:317-514-2095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-09
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty