Healthcare Provider Details

I. General information

NPI: 1184915217
Provider Name (Legal Business Name): RACHEL WHITNEY MCKENNA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2011
Last Update Date: 06/23/2025
Certification Date: 06/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4687 POUNCEY TRACT RD
GLEN ALLEN VA
23059-5802
US

IV. Provider business mailing address

415 N MULBERRY ST
RICHMOND VA
23220-3319
US

V. Phone/Fax

Practice location:
  • Phone: 804-422-5437
  • Fax:
Mailing address:
  • Phone: 801-907-1415
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101275029
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: