Individual
KATHRYN F MCKENNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
5213 GODFREY RD STE 110, GODFREY, IL 62035-2510
(618) 619-3330
Mailing address
5213 GODFREY RD STE 110, GODFREY, IL 62035-2510
(618) 619-3330
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209021685
IL
363LF0000X
Family Nurse Practitioner
209.021685
IL
Other
Enumeration date
08/03/2020
Last updated
01/03/2025
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