Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 37943 | KY |
Y | 2080P0210X | Pediatric Nephrologist | 01062203A | IN |
N | 2080P0210X | Pediatric Nephrologist | 37943 | KY |
NPI | 1215911201 |
---|---|
Provider Name | Daniel W Mckenney |
First Address | Indianapolis, IN 46290-1024 |
Second Address | Indianapolis, IN 46260-2052 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/12/2005 |
Last Update Date | 07/09/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200442070 | (05) | IN |
6406998200 | (05) | KY |
G08739 | (02) |