| Doctor Name: | MARTHA JO MCKINNEY |
| NPI Number: | 1003060203 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APN |
| License Number: | S02218 |
| Business Practice Address: | 1100 N College Ave Fayetteville, AR - 727031944 |
| Business Phone Number: | 4794434301 |
| Business Fax Number: | |
| Mailing Address: | 1100 N College Ave, FAYETTEVILLE |
| State: | AR |
| Postal Code: | 727031944 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 11/14/2008 |
| NPI Last Update Date: | 07/08/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 364SP0809X |
| License Number: | S02218 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AR |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Clinical Nurse Specialist |
| Taxonomy Specialization: | Psych/Mental Health, Adult |
| Taxonomy Definition: | |