MEDICARE: NEKEISHA N WILLIS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	246RP1900X	Phlebotomy Technician	G4D4K6J7	MI

General Provider Information

NPI Number	:	1801755186
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NEKEISHA N WILLIS

Provider Business Mailing Address
First Line	:	2154 FOX HILL DR APT 4
Second Line	:
City	:	GRAND BLANC
State	:	MI
Zip	:	48439-5207
Country	:	US
Telephone Number	:	810-268-8427
Fax Number	:

Provider Business Practice Location Address
First Line	:	2154 FOX HILL DR APT 4
Second Line	:
City	:	GRAND BLANC
State	:	MI
Zip	:	48439-5207
Country	:	US
Telephone Number	:	810-268-8427
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/21/2026
Last Update Date	:	01/21/2026

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Directions to “ NEKEISHA N WILLIS ” Practice Location

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