MEDICARE: MS. NAKIA YVETTE GULLETT RN

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	163W00000X	Registered Nurse	4704280170	MI

General Provider Information

NPI Number	:	1942167820
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. NAKIA YVETTE GULLETT RN

Provider Business Mailing Address
First Line	:	26691 FRANKLIN POINTE DR
Second Line	:
City	:	SOUTHFIELD
State	:	MI
Zip	:	48034-5616
Country	:	US
Telephone Number	:	313-528-5390
Fax Number	:	313-831-3910

Provider Business Practice Location Address
First Line	:	1240 3RD ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48226-2505
Country	:	US
Telephone Number	:	313-831-3160
Fax Number	:

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

Provider Enumeration Date	:	01/05/2026
Last Update Date	:	01/05/2026

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