Provider Demographics
NPI:1952283335
Name:MCKENNEY, LAMIRTA
Entity type:Individual
Prefix:
First Name:LAMIRTA
Middle Name:
Last Name:MCKENNEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6735 SELKIRK ST UNIT 92
Mailing Address - Street 2:
Mailing Address - City:BONNERS FERRY
Mailing Address - State:ID
Mailing Address - Zip Code:83805-8662
Mailing Address - Country:US
Mailing Address - Phone:661-485-9287
Mailing Address - Fax:
Practice Address - Street 1:6735 SELKIRK ST UNIT 92
Practice Address - Street 2:
Practice Address - City:BONNERS FERRY
Practice Address - State:ID
Practice Address - Zip Code:83805-8662
Practice Address - Country:US
Practice Address - Phone:661-485-9287
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-24
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care