Provider Demographics
NPI:1578334363
Name:MCKINLEY, AKIA KORNATH
Entity Type:Individual
Prefix:
First Name:AKIA
Middle Name:KORNATH
Last Name:MCKINLEY
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 1:4096 DAWLEY RD
Mailing Address - Street 2:
Mailing Address - City:RAVENNA
Mailing Address - State:OH
Mailing Address - Zip Code:44266-9404
Mailing Address - Country:US
Mailing Address - Phone:216-203-3331
Mailing Address - Fax:
Practice Address - Street 1:10735 RAVENNA RD
Practice Address - Street 2:
Practice Address - City:TWINSBURG
Practice Address - State:OH
Practice Address - Zip Code:44087-3107
Practice Address - Country:US
Practice Address - Phone:234-346-1416
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-11
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator