Individual
MCKENNA TAMMO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5131 E SOUTHERN AVE, MESA, AZ 85206-2799
(602) 933-0002
Mailing address
2108 E THOMAS RD STE 130, PHOENIX, AZ 85016-0008
(602) 933-3124
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10069
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
186052
—
AZ
Enumeration date
10/16/2023
Last updated
07/16/2024
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