Provider Demographics
NPI:1306677315
Name:STRAWS, KENYETTA
Entity type:Individual
Prefix:MRS
First Name:KENYETTA
Middle Name:
Last Name:STRAWS
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:PO BOX 35063
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48235-0063
Mailing Address - Country:US
Mailing Address - Phone:313-758-9040
Mailing Address - Fax:
Practice Address - Street 1:17331 E WARREN AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48224-2215
Practice Address - Country:US
Practice Address - Phone:313-753-8495
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula