Individual
ELLENA M. MCKENNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
400 N PEPPER AVE, COLTON, CA 92324-1801
(909) 580-6320
(909) 580-6334
Mailing address
400 N PEPPER AVE, COLTON, CA 92324-1801
(909) 580-6320
(909) 580-6334
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
NMW1167
CA
Other
Enumeration date
11/29/2006
Last updated
07/08/2007
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