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NPI Code Detail

MEDICARE: KENNAYA YAUQUAN DAVIS LPN

MEDICARE: KENNAYA YAUQUAN DAVIS LPN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1164W00000XLicensed Practical Nurse4703127058MI

General Provider Information

NPI Number : 1023734647
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENNAYA YAUQUAN DAVIS LPN
Provider Business Mailing Address
First Line : 37450 SCHOOLCRAFT RD
Second Line :
City : LIVONIA
State : MI
Zip : 48150-1082
Country : US
Telephone Number : 734-458-4601
Fax Number :
Provider Business Practice Location Address
First Line : 43825 MICHIGAN AVE
Second Line :
City : CANTON
State : MI
Zip : 48188-2551
Country : US
Telephone Number : 734-397-3088
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/14/2022
Last Update Date : 12/04/2025

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Directions to “ KENNAYA YAUQUAN DAVIS LPN” Practice Location

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