Provider Demographics
NPI:1447876271
Name:PLUMMER, NIKKI JO (AUD)
Entity type:Individual
Prefix:
First Name:NIKKI
Middle Name:JO
Last Name:PLUMMER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 W 39TH ST
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68845-8045
Mailing Address - Country:US
Mailing Address - Phone:308-865-2277
Mailing Address - Fax:308-865-2523
Practice Address - Street 1:615 W 39TH ST
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68845-8045
Practice Address - Country:US
Practice Address - Phone:308-865-2277
Practice Address - Fax:308-865-2523
Is Sole Proprietor?:No
Enumeration Date:2020-06-17
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE396231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist