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1265049324
JOHANNA CATHERINE MCKENNA
GAITHERSBURG, MD
NPI
1265049324
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Former Name
JOHANNA CATHERINE LAKE
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: MD R220471)
Enumeration Date
2020-09-23
Last Update Date
2021-02-23
Business Address
JOHANNA CATHERINE MCKENNA CRNP
317 E DIAMOND AVE STE C
GAITHERSBURG, MD 20877-5327
Phone number: 240-246-1111
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Mailing Address
JOHANNA CATHERINE MCKENNA CRNP
2802 URBANA DR
SILVER SPRING, MD 20906-5033
Phone number: 603-630-4454
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