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Individual
MS. JUDITH MCKENNA
Active
Individual
MS. JUDITH MCKENNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, NP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704145383
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4605447
—
MI
Enumeration date
11/04/2005
Last updated
05/27/2009
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