MEDICARE: MCKENNA SICKLER NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	RN251910	GA

General Provider Information

NPI Number	:	1427703883
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MCKENNA SICKLER NP

Provider Business Mailing Address
First Line	:	2729 NORTHWOODS DR N
Second Line	:
City	:	MACON
State	:	GA
Zip	:	31204-1621
Country	:	US
Telephone Number	:	678-787-1875
Fax Number	:

Provider Business Practice Location Address
First Line	:	3920 ARKWRIGHT RD STE 415
Second Line	:
City	:	MACON
State	:	GA
Zip	:	31210-1731
Country	:	US
Telephone Number	:	478-464-0612
Fax Number	:	478-464-0002

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/15/2022
Last Update Date	:	01/28/2025

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Directions to “ MCKENNA SICKLER NP” Practice Location

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