Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | R058407 | MD |
NPI | 1003893603 |
---|---|
Provider Name | Denise Lynn Mckinney |
First Address | Ft Meade, MD 20755-5800 |
Second Address | Apg, MD 21005-5131 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/12/2005 |
Last Update Date | 08/07/2007 |