MEDICARE: DR. JENNY MARIE MCKLVEEN DVM

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
1	174M00000X	Veterinarian	BV013023	PA

General Provider Information

NPI Number	:	1417395203
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JENNY MARIE MCKLVEEN DVM

Provider Business Mailing Address
First Line	:	159 ROSSMOR CT
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15229-3110
Country	:	US
Telephone Number	:	724-433-9323
Fax Number	:

Provider Business Practice Location Address
First Line	:	223 SIEBERT RD
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15237-3738
Country	:	US
Telephone Number	:	412-364-5353
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2013
Last Update Date	:	06/13/2013

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