Provider Demographics
NPI:1669716122
Name:RADFORD, NIKKI ANN (RN)
Entity type:Individual
Prefix:MS
First Name:NIKKI
Middle Name:ANN
Last Name:RADFORD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 PAINTED DR
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48843-7005
Mailing Address - Country:US
Mailing Address - Phone:248-444-7070
Mailing Address - Fax:
Practice Address - Street 1:7575 GRAND RIVER RD
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48114-9309
Practice Address - Country:US
Practice Address - Phone:810-844-7518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-21
Last Update Date:2012-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704278644163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency