Mckenna, Judith

Mckenna, Judith is an individual health care provider with primary practice located at 15855 19 Mile Rd , Clinton Township MI 48038-3504. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Mckenna, Judith can be contacted via phone (586) 295-5387.

Contact Information

Primary practice address
15855 19 Mile Rd Clinton Township MI 48038-3504
Phone: (586) 295-5387
Fax: (810) 794-4124
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 4704145383 Michigan

Profile Details

NPI number 1255322467
LBN Legal business name Mckenna, Judith
Credentials RN, NP
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 4th, 2005
Last updated May 27th, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255322467 NPPES
Michigan MEDICAID 4605447

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