Provider Demographics
NPI:1669286035
Name:RAYFORD, KENA ANEYSHIA
Entity type:Individual
Prefix:
First Name:KENA
Middle Name:ANEYSHIA
Last Name:RAYFORD
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 1:394 VINSON RD
Mailing Address - Street 2:
Mailing Address - City:BYHALIA
Mailing Address - State:MS
Mailing Address - Zip Code:38611-9354
Mailing Address - Country:US
Mailing Address - Phone:901-314-9045
Mailing Address - Fax:
Practice Address - Street 1:394 VINSON RD
Practice Address - Street 2:
Practice Address - City:BYHALIA
Practice Address - State:MS
Practice Address - Zip Code:38611-9354
Practice Address - Country:US
Practice Address - Phone:901-314-9045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-05
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1364253343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)