Provider Demographics
NPI:1164215059
Name:DAZA-FERMO, NIKKO GUILLERMO (MSN, RN)
Entity type:Individual
Prefix:MR
First Name:NIKKO
Middle Name:GUILLERMO
Last Name:DAZA-FERMO
Suffix:
Gender:M
Credentials:MSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10302 MOPAN RD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89178-4018
Mailing Address - Country:US
Mailing Address - Phone:808-227-2578
Mailing Address - Fax:
Practice Address - Street 1:10302 MOPAN RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89178-4018
Practice Address - Country:US
Practice Address - Phone:808-227-2579
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-23
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV886634163WH0200X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WH0200XNursing Service ProvidersRegistered NurseHome Health