Provider Demographics
NPI:1770637118
Name:MCKENNA, GREGORY FRANCIS (NP)
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:FRANCIS
Last Name:MCKENNA
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Gender:M
Credentials:NP
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Mailing Address - Street 1:165 CHARLES RIVER PLAZA
Mailing Address - Street 2:SUITE 404
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114
Mailing Address - Country:US
Mailing Address - Phone:617-726-9571
Mailing Address - Fax:617-724-0918
Practice Address - Street 1:165 CHARLES RIVER PLAZA
Practice Address - Street 2:SUITE 404
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114
Practice Address - Country:US
Practice Address - Phone:617-726-9571
Practice Address - Fax:617-724-0918
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA191283363LX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0106XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerOccupational Health