Kemi A Fabode, LPN

Primary specialty

Genetic Counselor (M.S.)Taxonomy code 170300000X

License

4703099353 Issued in MI

Practice address

26921 Kitch St
Inkster, MI 48141-2515

Phone

(586) 770-6464

Fax

(586) 772-4089

NPI assigned

Jan 23, 2019

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1548201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548201600000",
    "number": "1235693383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51859 LILLIAN RD",
            "city": "CHESTERFIELD",
            "state": "MI",
            "postal_code": "480473125",
            "telephone_number": "586-770-6464",
            "fax_number": "586-772-4089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26921 KITCH ST",
            "city": "INKSTER",
            "state": "MI",
            "postal_code": "481412515",
            "telephone_number": "586-770-6464",
            "fax_number": "586-772-4089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FABODE",
        "first_name": "KEMI",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-23",
        "last_updated": "2019-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": "MI",
            "license": "AS820385058",
            "primary": false
        },
        {
            "code": "170300000X",
            "taxonomy_group": "",
            "desc": "Genetic Counselor, MS",
            "state": "MI",
            "license": "4703099353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Genetic Counselor (M.S.) in Inkster, MI
• Providers in Inkster, MI by specialty
• Genetic Counselor (M.S.) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.