Individual
MISS JESSICA MCKINNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
700 KIMBER LANE, EVANSVILLE, IN 47715-2803
(812) 476-7111
(812) 476-7117
Mailing address
PO BOX 21890, BELFAST, ME 04915-4115
(502) 907-0356
(502) 919-9780
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
10003348A
IN
363AM0700X
Medical Physician Assistant
PA2900
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300054019
—
IN
05
—
7100764600
—
KY
Enumeration date
08/19/2021
Last updated
11/28/2022
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