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General NPI Number Information
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NPI Number | 1699344747
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Entity Type | Individual
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Provider Name | MCKENNA MEIHAK APNP
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Gender | Female
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Dates
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Enumeration Date | 06/23/2021
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Last Update Date | 02/07/2024
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Provider Practice Location Address
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Address Line | 200 E TYRANENA PARK RD
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City | LAKE MILLS
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State | WI
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Zip | 53551-9678
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Country | US
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Telephone | 920-648-8393
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Fax |
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Provider Business Mailing Address
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Address Line | 4 S BROWN ST APT 2
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City | RHINELANDER
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State | WI
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Zip | 54501-3449
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Country | US
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Telephone |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11023-33
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License Number State | WI
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