Individual
CHRISTINE NDUNGE NIKOLIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
6309 E BAYWOOD AVE STE 101, MESA, AZ 85206-1726
(480) 641-5400
(480) 218-4353
Mailing address
6309 E BAYWOOD AVE STE 101, MESA, AZ 85206-1726
(480) 641-5400
(480) 218-4353
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN121750
AZ
363LA2200X
Adult Health Nurse Practitioner
Primary
AP1691
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
836356
—
AZ
01
—
P00150020
RAILROAD MEDICARE
AZ
01
—
P00418321
RAILROAD MEDICARE
AZ
01
—
WCSKQ
SUN HEALTH GROUP #
AZ
Enumeration date
07/22/2005
Last updated
06/25/2025
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