MEDICARE: KISHA LYNISE KIRKSEY

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251B00000X	Case Management Agency
2	372600000X	Adult Companion
3	385HR2060X	Child Intellectual and/or Developmental Disabilities Respite Care
4	376J00000X	Homemaker

General Provider Information

NPI Number	:	1497552459
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KISHA LYNISE KIRKSEY

Provider Business Mailing Address
First Line	:	1916 NEWTON ST APT F
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44305-3067
Country	:	US
Telephone Number	:	330-689-6606
Fax Number	:

Provider Business Practice Location Address
First Line	:	1916 NEWTON ST APT F
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44305-3067
Country	:	US
Telephone Number	:	330-689-6606
Fax Number	:

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

Provider Enumeration Date	:	02/27/2025
Last Update Date	:	02/27/2025

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Directions to “ KISHA LYNISE KIRKSEY ” Practice Location

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