Most Relevant Information
Provider Data
| NPI Number: | 1003466335 |
| Provider Name: | SUSAN PATRICIA MCKENNA NP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LA2100X |
| Specialty: | Nurse Practitioner |
| License Number: | APRN02147 |
Most Important Dates
| Enumeration Date: | 09/18/2019 |
| Last Updated: | 09/18/2019 |
Provider Practice Location
1524 ATWOOD AVE STE 220
JOHNSTON
RI
029193278
Practice Location Phone/Fax
| Phone: | 4012721900 |
| Fax: |
Provider Mailing Location
1524 ATWOOD AVE STE 220
JOHNSTON
RI
029193278
Provider Mailing Phone/Fax
| Phone: | 4012721900 |
| Fax: | 4014533049 |