=====================================================
General NPI Number Information
=====================================================
NPI Number | 1982259024
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARGARET ROSE MCKERNAN P.A.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/06/2019
-----------------------------------------------------
Last Update Date | 10/21/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6150 PARK SQUARE DR. STE. B
-----------------------------------------------------
City | LORAIN
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44053-4153
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 440-984-6499
-----------------------------------------------------
Fax | 234-757-7545
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2000 AUBURN DR. STE. 350
-----------------------------------------------------
City | BEACHWOOD
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44122-4327
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 440-646-1600
-----------------------------------------------------
Fax | 440-646-1505
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363A00000X
-----------------------------------------------------
Taxonomy Name | Physician Assistant
-----------------------------------------------------
License Number | 50.006265RX
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------