Provider Demographics
NPI:1831438597
Name:NIKPOUR, NASRIN N/A (RNC-MNN, BSN, IBCLC)
Entity type:Individual
Prefix:MRS
First Name:NASRIN
Middle Name:N/A
Last Name:NIKPOUR
Suffix:
Gender:F
Credentials:RNC-MNN, BSN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 MORGAN PL
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-5006
Mailing Address - Country:US
Mailing Address - Phone:732-543-5982
Mailing Address - Fax:
Practice Address - Street 1:66 MORGAN PL
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-5006
Practice Address - Country:US
Practice Address - Phone:732-543-5982
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-31
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR13852700163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant