Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mrs. Nisha Kimberly McKenzie, PA-C

Individual provider Medical Physician Assistant · NPI 1770578676

Mrs. Nisha Kimberly McKenzie, PA-C is a Medical Physician Assistant in Grand Rapids, Michigan. Licensed in Michigan. Registered with an NPI since 2005.

Licensed in
MI
In the registry since
2005
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

630 Kenmoor Ave SE Ste 103
Grand Rapids, MI 49546-8626
Phone: (616) 600-4950
Fax: (855) 817-3028
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 5601003946 (MI)

Record details

NPI number1770578676
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedSeptember 16, 2005
Last updated in NPPESSeptember 18, 2020
Certification dateSeptember 18, 2020

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