| Doctor Name: | JENNIFER MCKINNON |
| NPI Number: | 1013037118 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | REGISTERED NURSE |
| License Number: | RN34333 |
| Business Practice Address: | 153 Summer St Providence, RI - 029034011 |
| Business Phone Number: | 4012764300 |
| Business Fax Number: | 4013313285 |
| Mailing Address: | 153 Summer St, PROVIDENCE |
| State: | RI |
| Postal Code: | 029034011 |
| Phone Number: | 4012764300 |
| Fax Number: | |
| NPI Enumeration Date: | 03/30/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP0200X |
| License Number: | RN34333 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | RI |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |