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NIKITA WALLER CNIM
NPI 1669907507
Specialist/Technologist, Other - Electroneurodiagnostic in Stonecrest, GA

Active since April 28, 2017
3635 PEBBLE ST, STONECREST, GA 30038(954) 668-4696 Get Directions Write a Review

NPPES record last updated: February 13, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 13, 2021, Jan 28, 2021, Sep 18, 2020 and 1 more (4 updates tracked since 2017).

About Nikita Waller Cnim NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NIKITA WALLER CNIM (NPI 1669907507) is an individual electroneurodiagnostic provider in Stonecrest, Georgia and active in the NPI registry since April 2017.

NPPES Registry Identity

NPI1669907507
Entity TypeIndividualFemale
Primary Taxonomy246ZE0600X
Provider Legal NameNIKITA WALLERCredential: CNIM
Location Address3635 PEBBLE STStonecrest, GA 30038-3395
Mailing Address3035 Se Maricamp Rd Ste 104-238Ocala, FL 34471-6201 · (954) 668-4696
Phone(954) 668-4696
Sole ProprietorNo
Enumeration DateApril 28, 2017
Last NPPES UpdateFebruary 13, 20214 updates tracked since enumeration
NPPES CertifiedFebruary 13, 2021
✔ NPI 1669907507 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialist/Technologist, Other · ElectroneurodiagnosticTechnologists, Technicians & Other Technical Service Providers
Taxonomy Code246ZE0600X
3635 PEBBLE ST, Stonecrest, GA 30038
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nikita Waller's NPI number?

The NPI number for Nikita Waller is 1669907507. It was assigned to this individual provider in the NPPES registry on April 28, 2017.

Where is Nikita Waller located?

Nikita Waller practices at 3635 Pebble St, Stonecrest, GA 30038. The listed phone number is (954) 668-4696.

What is Nikita Waller's specialty?

The primary specialty registered for this NPI is Specialist/Technologist, Other, specializing in Electroneurodiagnostic, with taxonomy code 246ZE0600X.

When was this NPI record last updated?

The NPPES record for Nikita Waller was last updated on February 13, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.