MCKENNA A GOTTFRIED

FORT WAYNE, IN
NPI1003328592
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: IN  71007667A)
Additional Taxonomies163W00000X Registered Nurse
(Licence: IN  28194377A)
363L00000X Nurse Practitioner
(Licence: OH  APRN.CNP.0036791)
Enumeration Date2017-10-25
Last Update Date2024-07-30
Business Address
MCKENNA A GOTTFRIED
3909 NEW VISION DR
FORT WAYNE, IN 46845-1725
Phone number: 260-425-5500
Mailing Address
MCKENNA A GOTTFRIED
11109 PARKVIEW PLAZA DR # 117
FORT WAYNE, IN 46845-1701
Phone number: