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General NPI Number Information
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NPI Number | 1861243735
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Entity Type | Individual
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Provider Name | KEIARIA PRINCE CNA
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Gender | Female
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Dates
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Enumeration Date | 03/28/2024
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Last Update Date | 08/14/2024
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Provider Practice Location Address
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Address Line | 1825 E TROY ST
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City | FERNDALE
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State | MI
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Zip | 48220-2016
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Country | US
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Telephone | 313-610-3313
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Fax |
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Provider Business Mailing Address
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Address Line | 1825 E TROY ST
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City | FERNDALE
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State | MI
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Zip | 48220-2016
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Country | US
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Telephone | 313-610-3313
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 146D00000X
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Taxonomy Name | Personal Emergency Response Attendant
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License Number |
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State | MI
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Taxonomy #5
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State | MI
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Taxonomy #6
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number |
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License Number State | MI
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Taxonomy #7
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State | MI
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Taxonomy #8
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion Agency
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License Number |
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License Number State | MI
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Taxonomy #9
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State | MI
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Taxonomy #10
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State | MI
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Taxonomy #11
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Taxonomy Code | 372500000X
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Taxonomy Name | Chore Provider
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License Number |
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License Number State | MI
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Taxonomy #12
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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License Number State | MI
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Taxonomy #13
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number |
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License Number State | MI
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Taxonomy #14
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State | MI
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Taxonomy #15
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number | 0618202222861
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License Number State | MI
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