Provider Demographics
NPI:1245968510
Name:RODRIGUEZ, MCKENNA (CD(DONA))
Entity type:Individual
Prefix:
First Name:MCKENNA
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:CD(DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67-207 KAHAONE LOOP
Mailing Address - Street 2:
Mailing Address - City:WAIALUA
Mailing Address - State:HI
Mailing Address - Zip Code:96791-8514
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:67-207 KAHAONE LOOP
Practice Address - Street 2:
Practice Address - City:WAIALUA
Practice Address - State:HI
Practice Address - Zip Code:96791-8514
Practice Address - Country:US
Practice Address - Phone:937-823-4003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-12
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula