Individual
SIDNEY M MCKINLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
1911 JACKSON ST, MONROE, LA 71202-2531
(318) 615-0015
(318) 330-7648
Mailing address
1911 JACKSON ST, MONROE, LA 71202-2531
(318) 615-0015
(318) 615-0015
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
05599
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020914
LOUISIANA STATE BOARD OF NURSING PERSCRIPTIVE AUTHORITY
LA
01
—
05599
ADVANCED PRACTICE
LA
01
—
096467
RN
LA
05
—
1348848
—
LA
Enumeration date
09/16/2008
Last updated
04/19/2024
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