Provider Demographics
NPI:1033943956
Name:SESE, NIKKI (RN)
Entity type:Individual
Prefix:
First Name:NIKKI
Middle Name:
Last Name:SESE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19113 SARICHEF LOOP
Mailing Address - Street 2:
Mailing Address - City:EAGLE RIVER
Mailing Address - State:AK
Mailing Address - Zip Code:99577-8631
Mailing Address - Country:US
Mailing Address - Phone:910-885-3838
Mailing Address - Fax:
Practice Address - Street 1:1500 DEBARR CIR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-2984
Practice Address - Country:US
Practice Address - Phone:907-258-7575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-02
Last Update Date:2024-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC360395163WP0808X
AK214214163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health