Provider Demographics
NPI:1902558240
Name:ATKINS, NIKHOL JANEEN
Entity Type:Individual
Prefix:
First Name:NIKHOL
Middle Name:JANEEN
Last Name:ATKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23020 MARLOW ST
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48237-2417
Mailing Address - Country:US
Mailing Address - Phone:248-632-3734
Mailing Address - Fax:
Practice Address - Street 1:7800 W OUTER DR STE 203
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48235-3459
Practice Address - Country:US
Practice Address - Phone:313-259-1574
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-18
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator