Provider Demographics
NPI:1255155248
Name:WILLIAMS, NAKISHA N (CNA)
Entity type:Individual
Prefix:
First Name:NAKISHA
Middle Name:N
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:NAKISHA
Other - Middle Name:N
Other - Last Name:BROYLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1985 UNION AVE APT 1D
Mailing Address - Street 2:
Mailing Address - City:BENTON HARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:49022-6232
Mailing Address - Country:US
Mailing Address - Phone:269-267-8905
Mailing Address - Fax:
Practice Address - Street 1:1985 UNION AVE APT 1D
Practice Address - Street 2:
Practice Address - City:BENTON HARBOR
Practice Address - State:MI
Practice Address - Zip Code:49022-6232
Practice Address - Country:US
Practice Address - Phone:269-267-8905
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-14
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health