Provider Demographics
NPI:1831841469
Name:WALKER, NIKKI (CCMA, CPT)
Entity type:Individual
Prefix:
First Name:NIKKI
Middle Name:
Last Name:WALKER
Suffix:
Gender:F
Credentials:CCMA, CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3924 LEATHERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32065-5527
Mailing Address - Country:US
Mailing Address - Phone:334-233-1485
Mailing Address - Fax:
Practice Address - Street 1:1730 KINGSLEY AVE
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-4496
Practice Address - Country:US
Practice Address - Phone:334-233-1485
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-25
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service