Individual
MRS. NIKKI MARIE MALLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1500 N WESTWOOD BLVD, POPLAR BLUFF, MO 63901-3318
(573) 686-4151
(573) 778-4260
Mailing address
1500 N WESTWOOD BLVD, POPLAR BLUFF, MO 63901-3318
(573) 686-4151
(573) 778-4260
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
2015043931
MO
363LF0000X
Family Nurse Practitioner
Primary
277000304
IL
Other
Enumeration date
08/18/2016
Last updated
05/12/2023
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