Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kanisha Petty

Individual provider Licensed Practical Nurse · NPI 1174313621

Kanisha Petty is a Licensed Practical Nurse in Brooklyn, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2025

Practice location Address checks out

1115 Avenue U
Brooklyn, NY 11223-5019
Phone: (718) 717-8337
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Licensed Practical Nurse (primary) Taxonomy 164W00000X · Licence 348755-01 (NY)

Record details

NPI number1174313621
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMay 8, 2025
Last updated in NPPESMay 8, 2025
Certification dateMay 8, 2025

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