NPI age
9 years
Enumerated 2017-04-28
● Active
Type 1 · Individual
Nikita Waller, CNIM
Waller is 1 of 1 specialist/technologist, other providers in Stonecrest and 1 of 135 in Georgia.
Primary specialty
Specialist/Technologist, Other
Licensed in
—
0 states
Status
Active
No deactivations on record
Last NPPES update
2021-02-13
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 135 active specialist/technologist, other providers in Georgia.
NPI age
9 years
≈ at median (10 yr)
State licenses
1 state
0% of peers hold multiple states
Subspecialties
0
11% of peers hold subspecialties
NPI lifetime · 2017 → 2026
2017-04Enumerated in NPPES
2017
2026
Where they practice
Practice location
3635 Pebble St
Stonecrest, GA 300383395
Mailing address
3035 Se Maricamp Rd Ste 104-238
Ocala, FL 344716201
Specialties
-
Specialist/Technologist, Other PrimaryDefinition to come...
Practice context
Solo or small practice. No other active providers share this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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