Mckenna, Kimberly Rose

Mckenna, Kimberly Rose is an sole proprietor health care provider with primary practice located at 106 Winston Way , Campbellsville KY 42718-4953. She recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Rural Health, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Mckenna, Kimberly Rose can be contacted via phone (270) 789-0034.

Contact Information

Primary practice address
106 Winston Way Campbellsville KY 42718-4953
Fax: (270) 789-0097
Website:

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Rural Health 261QR1300X Kentucky
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 4091P Kentucky

Profile Details

NPI number 1295810786
LBN Legal business name Mckenna, Kimberly Rose
Credentials ARNP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 25th, 2006
Last updated Feb 15th, 2023 - about last year

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 1295810786 NPPES
Kentucky MEDICAID 78012481

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