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NPI Code Detail

MEDICARE: MRS. KENYETTA STRAWS

MEDICARE:  MRS. KENYETTA  STRAWS
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
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General Provider Information

NPI Number : 1306677315
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KENYETTA STRAWS
Provider Business Mailing Address
First Line : PO BOX 35063
Second Line :
City : DETROIT
State : MI
Zip : 48235-0063
Country : US
Telephone Number : 313-758-9040
Fax Number :
Provider Business Practice Location Address
First Line : 17331 E WARREN AVE
Second Line :
City : DETROIT
State : MI
Zip : 48224-2215
Country : US
Telephone Number : 313-753-8495
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2024
Last Update Date : 08/12/2024

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Directions to “ MRS. KENYETTA STRAWS ” Practice Location

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