Provider Demographics
NPI:1720347289
Name:FARMER, NIKKO (RN)
Entity Type:Individual
Prefix:
First Name:NIKKO
Middle Name:
Last Name:FARMER
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 1:4 AUCHLY LN
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-2036
Mailing Address - Country:US
Mailing Address - Phone:314-435-8424
Mailing Address - Fax:866-950-4040
Practice Address - Street 1:4 AUCHLY LN
Practice Address - Street 2:
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-2036
Practice Address - Country:US
Practice Address - Phone:314-435-8424
Practice Address - Fax:866-950-4040
Is Sole Proprietor?:No
Enumeration Date:2012-05-03
Last Update Date:2012-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2000149870163W00000X, 163WA2000X, 163WC0400X, 163WC1500X, 163WC1600X, 163WG0000X, 171M00000X
MO200149870163WH0500X
171M00000X, 172V00000X, 174H00000X, 372500000X, 372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163WH0500XNursing Service ProvidersRegistered NurseHemodialysis
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No172V00000XOther Service ProvidersCommunity Health Worker
No174H00000XOther Service ProvidersHealth Educator
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion