Individual
SARAH J MCKENNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2505 N ARLINGTON AVE, INDIANAPOLIS, IN 46218-3318
(317) 554-5300
(317) 554-5247
Mailing address
PO BOX 78158, INDIANAPOLIS, IN 46278-0158
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01061290A
IN
208000000X
Pediatrics Physician
01061290A
IN
208D00000X
General Practice Physician
Primary
01061290A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
068010957
MEDICARE PTAN
IN
01
—
1102489411
ANTHEM PTAN
IN
05
—
200401560
—
IN
Enumeration date
05/04/2006
Last updated
08/07/2024
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