Individual
MCKENNA JEAN KNYCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-6450
(414) 805-6464
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-6450
(414) 805-6464
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
4301102671
MI
207P00000X
Emergency Medicine Physician
Primary
73109
WI
207P00000X
Emergency Medicine Physician
MD0000057098
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013259613
—
WI
Enumeration date
03/21/2013
Last updated
07/31/2020
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