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NPI Code Detail

MEDICARE: MCKENNA D LOSS PNP-C

MEDICARE:   MCKENNA D LOSS  PNP-C
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
1363LP0200XPediatric Nurse Practitioner209020289IL

General Provider Information

NPI Number : 1336531409
Entity Type Code : Individual
Provider Name (Legal Business Name) : MCKENNA D LOSS PNP-C
Provider Business Mailing Address
First Line : PO BOX 155
Second Line :
City : CHRISTOPHER
State : IL
Zip : 62822-0155
Country : US
Telephone Number : 618-724-2401
Fax Number :
Provider Business Practice Location Address
First Line : 1007 W MAIN ST
Second Line :
City : FAIRFIELD
State : IL
Zip : 62837-2308
Country : US
Telephone Number : 618-842-4470
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/26/2015
Last Update Date : 02/06/2026

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Directions to “ MCKENNA D LOSS PNP-C” Practice Location

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