| Doctor Name: | NIKITIA BOOTH |
| NPI Number: | 1275990715 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 0024173183 |
| Business Practice Address: | 9000 Staples Mill Rd Henrico, VA - 232282021 |
| Business Phone Number: | 8049779526 |
| Business Fax Number: | |
| Mailing Address: | 9000 Staples Mill Rd, HENRICO |
| State: | VA |
| Postal Code: | 232282021 |
| Phone Number: | 8049779526 |
| Fax Number: | |
| NPI Enumeration Date: | 01/27/2016 |
| NPI Last Update Date: | 06/01/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 0024173183 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |