Provider Demographics
NPI:1588478564
Name:WILLIAMS, KENYATTA IKIA
Entity type:Individual
Prefix:
First Name:KENYATTA
Middle Name:IKIA
Last Name:WILLIAMS
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 1:151 N 8TH ST STE 350
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68508-1429
Mailing Address - Country:US
Mailing Address - Phone:531-500-3623
Mailing Address - Fax:
Practice Address - Street 1:910 RUTLAND DR APT 520
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68512-2128
Practice Address - Country:US
Practice Address - Phone:773-952-1660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-01
Last Update Date:2025-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion