Individual
NIKII VALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
340 STATELINE RD W, SOUTHAVEN, MS 38671-1610
(877) 969-2157
Mailing address
4016 MACAULAY CV, MEMPHIS, TN 38127-3937
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
56703
TN
Other
Enumeration date
03/29/2021
Last updated
03/29/2021
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