MEDICARE: KENISHA JOHNSON

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
1	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1215880851
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENISHA JOHNSON

Provider Business Mailing Address
First Line	:	835 MEADOW RIDGE CIR APT 201
Second Line	:	835 MEADOW RIDGE CIR APT 201
City	:	AUBURN HILLS
State	:	MI
Zip	:	48326-4551
Country	:	US
Telephone Number	:	248-904-8391
Fax Number	:

Provider Business Practice Location Address
First Line	:	835 MEADOW RIDGE CIR APT 201
Second Line	:	835 MEADOW RIDGE CIR APT 201
City	:	AUBURN HILLS
State	:	MI
Zip	:	48326-4551
Country	:	US
Telephone Number	:	248-904-8391
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/16/2026
Last Update Date	:	02/16/2026

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Directions to “ KENISHA JOHNSON ” Practice Location

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