Provider Demographics
NPI:1447345244
Name:MCKENNA, RACHEL A (CRNP)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:A
Last Name:MCKENNA
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:A
Other - Last Name:ARNOLD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:3401 CIVIC CENTER BLVD
Mailing Address - Street 2:WOOD BUILDING, 1ST FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-4319
Mailing Address - Country:US
Mailing Address - Phone:215-590-2208
Mailing Address - Fax:267-426-2950
Practice Address - Street 1:3401 CIVIC CENTER BLVD
Practice Address - Street 2:WOOD BUILDING, 1ST FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4319
Practice Address - Country:US
Practice Address - Phone:215-590-2208
Practice Address - Fax:267-426-2950
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2016-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP009041363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily