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Nakeisha Latice Micheaux

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

3601 The Vanderbilt Clinic, Nashville, TN 37232-0001

PECOS Enrollment

This provider is enrolled in PECOS as NAKEISHA MICHEAUX.

Based on the most recent information from CMS, provider Nakeisha Latice Micheaux is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 10:34 AM.

Profile Details

Provider ID
1417292087
Provider Type
Individual
Full Name
Micheaux, Nakeisha Latice
Title
Mrs.
Credential
APRN

Gender
Female
Sole Proprietor
Yes
Enumeration Date
12/7/2012
Last Updated
12/16/2025

Contact Information

Practice Location

3601 The Vanderbilt Clinic, Nashville, TN 37232-0001

(616) 322-3000

Unlisted Fax

Mailing Location

3841 Green Hills Village Dr Ste 200, Nashville, TN 37215-2691

Unlisted Phone

(615) 322-5048

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 17239 Tennessee
Code 363LX0106X	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 17239 Tennessee

Provider Identifiers

ID	Description	Issuer
ID Q017601	Description Medicaid	Issuer Unlisted Tennessee

Nakeisha Latice Micheaux

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Smith, Leaanne

Walden, Mary Ellen

Yelton, Nancy

Krasnow, Kayli

Cole, Brannan

Noga, Amanda Kathleen

Babanzadeh, Bawan

Reese, Kathryn

Long, Melissa Catherine

Smallwood, Emily Ruth