Individual
MS. NIKIKI CATHERINE MCCALLUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
617 CRABAPPLE PL, MACON, GA 31217-5575
(478) 952-3180
Mailing address
888 PIO NONO AVE, MACON, GA 31204-3536
(478) 952-3180
(866) 898-1099
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
—
—
310500000X
Mental Illness Intermediate Care Facility
—
—
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
347C00000X
Private Vehicle
—
—
3747P1801X
Personal Care Attendant
—
—
374U00000X
Home Health Aide
—
—
Other
Enumeration date
08/16/2011
Last updated
08/16/2011
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