Individual
NICOLE MCKENNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP, RN, BSN
Contact information
Practice address
1425 BEAVERCREEK RD, OREGON CITY, OR 97045-4076
(503) 655-8471
(503) 723-4946
Mailing address
2051 KAEN RD STE 367, OREGON CITY, OR 97045-4035
(503) 742-5300
(503) 742-5979
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
201041543RN
OR
363LF0000X
Family Nurse Practitioner
Primary
201506515NP-PP
OR
Other
Enumeration date
11/12/2013
Last updated
04/09/2024
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