Provider Demographics
NPI:1841541257
Name:GREENAWAY, NIKKI HUNTER (NP)
Entity type:Individual
Prefix:
First Name:NIKKI
Middle Name:HUNTER
Last Name:GREENAWAY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29207 DALEA CT
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-6063
Mailing Address - Country:US
Mailing Address - Phone:504-535-4913
Mailing Address - Fax:
Practice Address - Street 1:11222 RICHMOND AVE STE 201
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-2696
Practice Address - Country:US
Practice Address - Phone:504-539-5513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-25
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1057444363LP1700X, 363LW0102X
LAAP07023363LW0102X, 363LP1700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP1700XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPerinatal
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health