KENNA MACKENZIE CLEMENTS
NPI 1962106583
Student in an Organized Health Care Education/Training Program in Ypsilanti, MI

Active since March 28, 2023PECOS Enrolled
5333 MCAULEY DR RM 2110, YPSILANTI, MI 48197(734) 712-3967 Get Directions Write a Review

NPPES record last updated: March 28, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Kenna Mackenzie Clements NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KENNA MACKENZIE CLEMENTS (NPI 1962106583) is an individual student in an organized health care education/training program in Ypsilanti, Michigan and active in the NPI registry since March 2023. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1962106583
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameKENNA MACKENZIE CLEMENTS
Location Address5333 MCAULEY DR RM 2110Ypsilanti, MI 48197-1097
Mailing Address4291 Homestead DrHowell, MI 48843-9454
Sole ProprietorYes
Enumeration DateMarch 28, 2023
NPPES CertifiedMarch 28, 2023
NPI 1962106583 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Taxonomy Code390200000X
Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

5333 MCAULEY DR RM 2110, Ypsilanti, MI 48197

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Kenna Mackenzie Clements is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Social Worker (Clinical)
5333 MCAULEY DR RM 2110
YPSILANTI, MI 48197
Student in an Organized Health Care Education/Training Program
5333 MCAULEY DR RM 2110
YPSILANTI, MI 48197
Obstetrics & Gynecology
5333 MCAULEY DR RM 2110
YPSILANTI, MI 48197
Student in an Organized Health Care Education/Training Program
5333 MCAULEY DR RM 2110
YPSILANTI, MI 48197
Student in an Organized Health Care Education/Training Program
5333 MCAULEY DR RM 2110
YPSILANTI, MI 48197
Nurse Practitioner (Family)
5333 MCAULEY DR RM 2110
YPSILANTI, MI 48197
Student in an Organized Health Care Education/Training Program
5333 MCAULEY DR RM 2110
YPSILANTI, MI 48197
Obstetrics & Gynecology
5333 MCAULEY DR RM 2110
YPSILANTI, MI 48197

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1962106583, enumerated as an "individual" on March 28, 2023.

The provider is located at 5333 MCAULEY DR RM 2110 YPSILANTI, MI 48197 and the phone number is (734) 712-3967.

Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.