Mckenna A Gottfried
Nurse Practitioner
5693 Ymca Park Dr W
Fort Wayne
, Indiana 46835-3280
Mckenna A Gottfried
Nurse Practitioner
5693 Ymca Park Dr W
Fort Wayne
, Indiana 46835-3280
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About
Features
Specialties
- Nurse Practitioner
Languages spoken
- English
Location
First Address
- Mckenna A Gottfried
- 11109 Parkview Plaza Dr # 117
- Fort Wayne, IN
- Zip : 46845-1701
- Phone :
Second Address
- Mckenna A Gottfried
- 5693 Ymca Park Dr W
- Fort Wayne, IN
- Zip : 46835-3280
- Phone : (260) 425-6500
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 71007667A | IN |
National Provider Identifier
| NPI | 1003328592 |
|---|---|
| Provider Name | Mckenna A Gottfried |
| First Address | Fort Wayne, IN 46845-1701 |
| Second Address | Fort Wayne, IN 46835-3280 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 25/10/2017 |
| Last Update Date | 29/06/2021 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.