Provider Demographics
NPI:1508453440
Name:ADAMS, T'KEYA C
Entity Type:Individual
Prefix:
First Name:T'KEYA
Middle Name:C
Last Name:ADAMS
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 1:404 KANAWHA CT
Mailing Address - Street 2:
Mailing Address - City:SAINT ALBANS
Mailing Address - State:WV
Mailing Address - Zip Code:25177-3073
Mailing Address - Country:US
Mailing Address - Phone:818-720-5684
Mailing Address - Fax:
Practice Address - Street 1:404 KANAWHA CT
Practice Address - Street 2:
Practice Address - City:SAINT ALBANS
Practice Address - State:WV
Practice Address - Zip Code:25177-3073
Practice Address - Country:US
Practice Address - Phone:818-720-5684
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-27
Last Update Date:2020-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant