Provider Demographics
NPI:1447377916
Name:MCKINNEY, ANN L (LIC AC)
Entity type:Individual
Prefix:MRS
First Name:ANN
Middle Name:L
Last Name:MCKINNEY
Suffix:
Gender:F
Credentials:LIC AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 CHAPMAN LN
Mailing Address - Street 2:
Mailing Address - City:PEPPERELL
Mailing Address - State:MA
Mailing Address - Zip Code:01463-1419
Mailing Address - Country:US
Mailing Address - Phone:978-877-6794
Mailing Address - Fax:
Practice Address - Street 1:493 MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:GROTON
Practice Address - State:MA
Practice Address - Zip Code:01450-4254
Practice Address - Country:US
Practice Address - Phone:978-877-6794
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA229949171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist