Individual
DR. DEBORAH MCKENNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, AGPCNP, PMHNP
Contact information
Practice address
830 CHALKSTONE AVE, PROVIDENCE, RI 02908-4734
(401) 273-7100
Mailing address
830 CHALKSTONE AVE, PROVIDENCE, RI 02908-4734
(401) 273-7100
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN01844
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
APRN01844
RI APRN LICENSE
RI
01
—
CAPRN01844
CONTROLLED SUBSTANCES ACT REGISTRATION (CSR) - RI
RI
Enumeration date
07/02/2018
Last updated
02/06/2023
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