Healthcare Provider Details

I. General information

NPI: 1659710861
Provider Name (Legal Business Name): NEKEA KEANNIE FRANKLIN ACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2013
Last Update Date: 03/21/2023
Certification Date: 03/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34815 W MICHIGAN AVE STE. C
WAYNE MI
48184-1799
US

IV. Provider business mailing address

34815 W MICHIGAN AVE STE. C
WAYNE MI
48184-1799
US

V. Phone/Fax

Practice location:
  • Phone: 734-721-4739
  • Fax: 734-721-9448
Mailing address:
  • Phone: 734-721-4739
  • Fax: 734-721-9448

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number4704241477
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number4704241477
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: