Doctor Name: | LAURA LORRAINE MCKENNA |
NPI Number: | 1003065517 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NNP |
License Number: | F350142-01 |
Business Practice Address: | 259 1st St Mineola, NY - 115013957 |
Business Phone Number: | 5166632406 |
Business Fax Number: | 5166633759 |
Mailing Address: | 259 1st St, MINEOLA |
State: | NY |
Postal Code: | 115013957 |
Phone Number: | 5166632406 |
Fax Number: | 5166633759 |
NPI Enumeration Date: | 09/09/2008 |
NPI Last Update Date: | 09/09/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LN0000X |
License Number: | F350142-01 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Neonatal |
Taxonomy Definition: |