Provider Demographics
NPI:1487854121
Name:CURRIE, KENOSHA (CNA)
Entity Type:Individual
Prefix:
First Name:KENOSHA
Middle Name:
Last Name:CURRIE
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4828 MCCOOK AVE
Mailing Address - Street 2:
Mailing Address - City:EAST CHICAGO
Mailing Address - State:IN
Mailing Address - Zip Code:46312-3880
Mailing Address - Country:US
Mailing Address - Phone:219-397-8038
Mailing Address - Fax:
Practice Address - Street 1:4828 MCCOOK AVE
Practice Address - Street 2:
Practice Address - City:EAST CHICAGO
Practice Address - State:IN
Practice Address - Zip Code:46312-3880
Practice Address - Country:US
Practice Address - Phone:219-397-8038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-20
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN44-03-01-00147374U00000X
IN45-01-98-15764376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No376K00000XNursing Service Related ProvidersNurse's Aide