Provider Demographics
NPI:1831986157
Name:SPY, KENYADA
Entity type:Individual
Prefix:
First Name:KENYADA
Middle Name:
Last Name:SPY
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 1:1418 SAFFIRA WAY
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-3634
Mailing Address - Country:US
Mailing Address - Phone:330-388-8799
Mailing Address - Fax:
Practice Address - Street 1:1418 SAFFIRA WAY
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-3634
Practice Address - Country:US
Practice Address - Phone:330-388-8799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-21
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX48673029343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)