Individual
STACEY A MCKENNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AA
Contact information
Practice address
111 COLCHESTER AVE, BURLINGTON, VT 05401-1473
(802) 847-2415
(802) 847-5324
Mailing address
111 COLCHESTER AVE, BURLINGTON, VT 05401-1473
(802) 847-2415
(802) 847-5324
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
135.0000038
VT
367H00000X
Anesthesiologist Assistant
4646
GA
Other
Enumeration date
08/31/2006
Last updated
04/06/2015
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