Individual
MRS. LISA MICHELLE MCKINNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1946 45TH ST, MUNSTER, IN 46321-3986
(219) 703-2420
(219) 703-6765
Mailing address
8558 BROADWAY, MERRILLVILLE, IN 46410-7032
(219) 392-7084
(219) 703-6854
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
209-017275
IL
363LF0000X
Family Nurse Practitioner
Primary
71008252A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300006669
—
IN
Enumeration date
04/24/2018
Last updated
04/27/2023
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