Individual
MAKENNA JO JOHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
15-02693
KS
363AM0700X
Medical Physician Assistant
15-02693
KS
363AS0400X
Surgical Physician Assistant
Primary
15-02693
KS
Other
Enumeration date
06/07/2022
Last updated
01/06/2026
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