Provider Demographics
NPI:1548472244
Name:BEHNER, NIKKI L (ARNP)
Entity type:Individual
Prefix:MS
First Name:NIKKI
Middle Name:L
Last Name:BEHNER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 N 1ST ST STE 55
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98273-2858
Mailing Address - Country:US
Mailing Address - Phone:360-588-4950
Mailing Address - Fax:360-873-8041
Practice Address - Street 1:117 N 1ST ST STE 55
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98273-2858
Practice Address - Country:US
Practice Address - Phone:360-588-4950
Practice Address - Fax:360-873-8041
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30001966363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2146061Medicaid
0124374OtherANCC CREDENTIAL
WAAP30001966OtherPROFESSIONAL ADVANCED PRACTICE NURSING LICENSE
WAAP30001966OtherPROFESSIONAL ADVANCED PRACTICE NURSING LICENSE