Individual
KAITLIN MARIE MCKENNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1032 S CESAR E CHAVEZ DR, MILWAUKEE, WI 53204-2203
(414) 672-1353
Mailing address
PO BOX 778789, CHICAGO, IL 60677-8789
(414) 672-1353
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
66342
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1043605512
—
WI
Enumeration date
04/01/2015
Last updated
06/26/2023
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