Provider Demographics
NPI:1467959189
Name:KAYE, MCKENNA (DPM)
Entity Type:Individual
Prefix:DR
First Name:MCKENNA
Middle Name:
Last Name:KAYE
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27593 HARPER AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48081-1923
Mailing Address - Country:US
Mailing Address - Phone:586-779-6140
Mailing Address - Fax:586-779-9865
Practice Address - Street 1:27593 HARPER AVE
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48081-1923
Practice Address - Country:US
Practice Address - Phone:586-779-6140
Practice Address - Fax:586-779-9865
Is Sole Proprietor?:No
Enumeration Date:2018-04-09
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY390200000X
MI5901400417213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program