MEDICARE: MISS KEAIRA MCKENZI-TIHEYA MARCUM DR

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	225X00000X	Occupational Therapist

General Provider Information

NPI Number	:	1659297786
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS KEAIRA MCKENZI-TIHEYA MARCUM DR

Provider Business Mailing Address
First Line	:	13372 HIGHWAY 421 N
Second Line	:
City	:	MC KEE
State	:	KY
Zip	:	40447-8727
Country	:	US
Telephone Number	:	859-353-8382
Fax Number	:

Provider Business Practice Location Address
First Line	:	116 MERIDIAN WAY STE 8
Second Line	:
City	:	RICHMOND
State	:	KY
Zip	:	40475-2876
Country	:	US
Telephone Number	:	859-353-8382
Fax Number	:

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

Provider Enumeration Date	:	06/24/2026
Last Update Date	:	06/24/2026

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