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NPI Code Detail

MEDICARE: MS. LAURA JANE MCKENNA CNM

MEDICARE: MS. LAURA JANE MCKENNA CNM
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
1367A00000XAdvanced Practice MidwifeF000931NY

General Provider Information

NPI Number : 1821184920
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LAURA JANE MCKENNA CNM
Provider Business Mailing Address
First Line : 287 E 17TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11226-5201
Country : US
Telephone Number : 718-282-0228
Fax Number : 718-282-0228
Provider Business Practice Location Address
First Line : 287 E 17TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11226-5201
Country : US
Telephone Number : 718-282-0228
Fax Number : 718-282-0228
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2006
Last Update Date : 07/08/2007

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