Individual
MCKENNA NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
PO BOX 600, TUBA CITY, AZ 86045-0600
(928) 856-4314
Mailing address
9550 STARDUST TRL, FLAGSTAFF, AZ 86004-1136
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
11412
AZ
363A00000X
Physician Assistant
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
12/06/2024
Last updated
03/23/2026
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