Mckinnie, Mary Jane

Mckinnie, Mary Jane is an sole proprietor health care provider with primary practice located at 905 11Th St , Lake Charles LA 70601-6230. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Mckinnie, Mary Jane can be contacted via phone (337) 433-7117.

Contact Information

Primary practice address
905 11Th St Lake Charles LA 70601-6230
Phone: (337) 433-7117
Fax: (337) 433-7117
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X AP05000 Louisiana

Profile Details

NPI number 1689774259
LBN Legal business name Mckinnie, Mary Jane
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 24th, 2006
Last updated Nov 13th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689774259 NPPES
Louisiana MEDICAID 1409171

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