Wilson, Nikki Renee

Wilson, Nikki Renee is an individual health care provider with primary practice located at 615 S New Ballas Rd , Saint Louis MO 63141-8221. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Wilson, Nikki Renee can be contacted via phone (314) 251-6663.

Contact Information

Primary practice address
615 S New Ballas Rd Saint Louis MO 63141-8221
Phone: (314) 251-6663
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 1106348 Kentucky
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 2020014289 Missouri

Profile Details

NPI number 1831346204
LBN Legal business name Wilson, Nikki Renee
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 27th, 2008
Last updated Jul 11th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1831346204 NPPES
Kentucky MEDICAID 7100062540

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