| Doctor Name: | NIKKI MARIE MIRACLE |
| NPI Number: | 1205050754 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | D.P.M. |
| License Number: | SC005929 |
| Business Practice Address: | 6832 Big Beaver Blvd. Beaver Falls, PA - 150101803 |
| Business Phone Number: | 7248437010 |
| Business Fax Number: | 7248469938 |
| Mailing Address: | 6832 Big Beaver Blvd, BEAVER FALLS |
| State: | PA |
| Postal Code: | 150101803 |
| Phone Number: | 7248437010 |
| Fax Number: | 7248469938 |
| NPI Enumeration Date: | 04/13/2007 |
| NPI Last Update Date: | 11/04/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0131X |
| License Number: | SC005929 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot Surgery |
| Taxonomy Definition: | |