Provider Demographics
NPI:1548010275
Name:ALLEN, KANEESHA
Entity type:Individual
Prefix:
First Name:KANEESHA
Middle Name:
Last Name:ALLEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13516 OAKVIEW BLVD
Mailing Address - Street 2:
Mailing Address - City:GARFIELD HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44125-6053
Mailing Address - Country:US
Mailing Address - Phone:586-675-9146
Mailing Address - Fax:
Practice Address - Street 1:13516 OAKVIEW BLVD
Practice Address - Street 2:
Practice Address - City:GARFIELD HTS
Practice Address - State:OH
Practice Address - Zip Code:44125-6053
Practice Address - Country:US
Practice Address - Phone:586-675-9146
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide