Individual
MRS. DENA D MCKENNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAAA
Contact information
Practice address
777 HEMLOCK ST, MSC10, MACON, GA 31201-2102
(478) 633-1000
Mailing address
777 HEMLOCK ST, MSC10, MACON, GA 31201-2102
(478) 633-1000
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
003508
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003508
GA LIC NUMBER
GA
05
—
100001165C
—
GA
Enumeration date
04/06/2006
Last updated
04/10/2013
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