MEDICARE: KENISHA BEY

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	3747P1801X	Personal Care Attendant
2	376J00000X	Homemaker
3	172A00000X	Driver	ST759276	OH

General Provider Information

NPI Number	:	1336018555
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENISHA BEY

Provider Business Mailing Address
First Line	:	1008 YELLOWSTONE RD
Second Line	:
City	:	CLEVELAND HTS
State	:	OH
Zip	:	44121-1423
Country	:	US
Telephone Number	:	216-972-1611
Fax Number	:

Provider Business Practice Location Address
First Line	:	1008 YELLOWSTONE RD
Second Line	:
City	:	CLEVELAND HTS
State	:	OH
Zip	:	44121-1423
Country	:	US
Telephone Number	:	216-972-1611
Fax Number	:

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

Provider Enumeration Date	:	11/04/2025
Last Update Date	:	11/04/2025

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Directions to “ KENISHA BEY ” Practice Location

Language	Start Address	Practice Location

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