| Doctor Name: | MS. NIKKI LASHELLE BURLESON |
| NPI Number: | 1699939553 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CRNP |
| License Number: | 1-079470 |
| Business Practice Address: | 42320 Highway 195 Haleyville, AL - 355657064 |
| Business Phone Number: | 2054868899 |
| Business Fax Number: | 2054868908 |
| Mailing Address: | 42320 Highway 195, HALEYVILLE |
| State: | AL |
| Postal Code: | 355657064 |
| Phone Number: | 2054868899 |
| Fax Number: | 2054868908 |
| NPI Enumeration Date: | 07/10/2008 |
| NPI Last Update Date: | 10/23/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 1-079470 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |