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General NPI Number Information
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NPI Number | 1275915589
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Entity Type | Individual
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Provider Name | JENNIFER LEE MCKINNEY RN, WHNP-BC, IBCLC
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Gender | Female
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Dates
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Enumeration Date | 06/23/2015
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Last Update Date | 06/23/2015
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Provider Practice Location Address
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Address Line | 2270 SPEAR POINT TRL
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City | MARIETTA
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State | GA
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Zip | 30062-2548
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Country | US
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Telephone | 404-731-9310
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Fax |
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Provider Business Mailing Address
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Address Line | 2270 SPEAR POINT TRL
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City | MARIETTA
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State | GA
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Zip | 30062-2548
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Country | US
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Telephone | 404-731-9310
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WW0101X
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Taxonomy Name | Ambulatory Women's Health Care Registered Nurse
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License Number | 179661
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License Number State | GA
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