Provider Demographics
NPI:1770975922
Name:JENNY MCKINNEY
Entity type:Organization
Organization Name:JENNY MCKINNEY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/CASE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:MCKINNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-258-9243
Mailing Address - Street 1:981 PRAIRIE RIVER DR
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82604-2113
Mailing Address - Country:US
Mailing Address - Phone:307-258-9243
Mailing Address - Fax:307-337-2579
Practice Address - Street 1:981 PRAIRIE RIVER DR
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82604-2113
Practice Address - Country:US
Practice Address - Phone:307-258-9243
Practice Address - Fax:307-337-2579
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-25
Last Update Date:2015-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management