Provider Demographics
NPI:1275821274
Name:MCKENNA, LINDA FRANCES (FNP)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:FRANCES
Last Name:MCKENNA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1351 ROUTE 55 STE 200
Mailing Address - Street 2:
Mailing Address - City:LAGRANGEVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12540-5128
Mailing Address - Country:US
Mailing Address - Phone:845-475-9622
Mailing Address - Fax:845-475-9938
Practice Address - Street 1:514 ROUTE 299
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:NY
Practice Address - Zip Code:12528-2835
Practice Address - Country:US
Practice Address - Phone:845-691-9200
Practice Address - Fax:845-691-3992
Is Sole Proprietor?:No
Enumeration Date:2011-07-12
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF336888363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03354134Medicaid