MEDICARE: SHYRHONDA KENEBREW

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	:	1548103310
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHYRHONDA KENEBREW

Provider Business Mailing Address
First Line	:	3433 POLK ST
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70607-2143
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	125 JAMESTOWN ST UNIT J
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70605-5711
Country	:	US
Telephone Number	:	337-508-2313
Fax Number	:

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

Provider Enumeration Date	:	04/14/2026
Last Update Date	:	04/14/2026

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Directions to “ SHYRHONDA KENEBREW ” Practice Location

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