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Individual
NIKKI SMITH
Active
Individual
NIKKI SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPAC
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0096561
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02502225
—
NY
01
—
P019009656
BLUE CHOICE
NY
Enumeration date
06/08/2006
Last updated
06/17/2013
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