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Individual
MCKENNA KELLY VANCE
Active
Individual
MCKENNA KELLY VANCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BS, APRN
Taxonomy
Speciality
Code
Description
License number
State
163WN0002X
Neonatal Intensive Care Registered Nurse
9428379-3102
UT
363LN0005X
Critical Care Neonatal Nurse Practitioner
Primary
9428379-4405
UT
Other
Enumeration date
04/22/2020
Last updated
02/11/2022
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