Individual
JENNA MACKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1107 STONE ST STE 3, PORT HURON, MI 48060-3569
(810) 204-4494
Mailing address
1107 STONE ST STE 3, PORT HURON, MI 48060-3569
(810) 204-4494
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601013812
MI
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
11/01/2023
Last updated
03/27/2026
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