Provider Demographics
NPI:1114651049
Name:MCDONOUGH, JOHN KENNETH COLE (DNP, AGACNP-BC, , RN)
Entity Type:Individual
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First Name:JOHN KENNETH
Middle Name:COLE
Last Name:MCDONOUGH
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Gender:M
Credentials:DNP, AGACNP-BC, , RN
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Mailing Address - Street 1:909 HEDGEROW CT
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-5518
Mailing Address - Country:US
Mailing Address - Phone:410-459-8721
Mailing Address - Fax:
Practice Address - Street 1:EMORY UNIVERSITY HOSPITAL 1364 E CLIFTON RD N
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-0001
Practice Address - Country:US
Practice Address - Phone:404-712-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-15
Last Update Date:2023-09-12
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Provider Licenses
StateLicense IDTaxonomies
NY802840163W00000X
GA313409163W00000X
NY432363363LA2100X
GANCO-000003363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse