Individual
JANE CLAIR MCKENNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3975 FAIR RIDGE DR # 125, FAIRFAX, VA 22033-2911
(703) 259-8423
Mailing address
3975 FAIR RIDGE DR # 125, FAIRFAX, VA 22033-2911
(032) 598-4237
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
0024187051
VA
363LA2100X
Acute Care Nurse Practitioner
AP139613
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
397549201
—
TX
Enumeration date
11/08/2018
Last updated
02/06/2025
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