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Individual
JANICE MARIE MCKENNEY
Active
Individual
JANICE MARIE MCKENNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3733
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0002386
WELLMAK BCBS
SD
05
—
5600270
—
SD
01
—
A016
TRICARE
—
Enumeration date
08/12/2005
Last updated
01/24/2019
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