Doctor Name: | KATHERINE A. MCKENNEY |
NPI Number: | 1295778207 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CRNP |
License Number: | 353420-22 |
Business Practice Address: | 1313 National Hwy Lavale, MD - 215027618 |
Business Phone Number: | 2403620288 |
Business Fax Number: | 2403620052 |
Mailing Address: | 1313 National Hwy, LAVALE |
State: | MD |
Postal Code: | 215027618 |
Phone Number: | 2403620288 |
Fax Number: | 2403620052 |
NPI Enumeration Date: | 06/14/2006 |
NPI Last Update Date: | 10/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 353420-22 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |