Individual
MCKENNA MARIE EL YEZIOUY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6379 CENTER DR, NORFOLK, VA 23502-4102
(757) 467-4200
Mailing address
6379 CENTER DR, NORFOLK, VA 23502-4102
(757) 467-4200
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110009720
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/05/2023
Last updated
01/10/2024
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