Provider Demographics
NPI:1861857583
Name:KILLINGS, NEKISHA (MPH, IBCLC)
Entity Type:Individual
Prefix:MRS
First Name:NEKISHA
Middle Name:
Last Name:KILLINGS
Suffix:
Gender:F
Credentials:MPH, IBCLC
Other - Prefix:MRS
Other - First Name:NIKKI
Other - Middle Name:
Other - Last Name:KILLINGS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:IBCLC
Mailing Address - Street 1:3425 BAYSIDE LAKES BLVD SE # 103-1032
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32909-6867
Mailing Address - Country:US
Mailing Address - Phone:805-793-0499
Mailing Address - Fax:
Practice Address - Street 1:3425 BAYSIDE LAKES BLVD SE # 103-1032
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32909-6867
Practice Address - Country:US
Practice Address - Phone:805-793-0499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-22
Last Update Date:2021-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLL-82473174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN