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NPI Code Detail

MEDICARE: JENNIFER NICOLE MCKEON

MEDICARE: JENNIFER NICOLE MCKEON
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
1390200000XStudent in an Organized Health Care Education/Training ProgramOR

General Provider Information

NPI Number : 1366301269
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER NICOLE MCKEON
Provider Business Mailing Address
First Line : 589 DUBLIN AVE
Second Line :
City : EUGENE
State : OR
Zip : 97404-1358
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1460 G ST
Second Line :
City : SPRINGFIELD
State : OR
Zip : 97477-4112
Country : US
Telephone Number : 541-726-4400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/17/2026
Last Update Date : 01/17/2026

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Directions to “ JENNIFER NICOLE MCKEON ” Practice Location

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