Provider Demographics
NPI:1750920906
Name:MCKINNEY, STEPHANIE MAY (WHNP-BC)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:MAY
Last Name:MCKINNEY
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22742 CENTER RD
Mailing Address - Street 2:
Mailing Address - City:HOMEWORTH
Mailing Address - State:OH
Mailing Address - Zip Code:44634-9707
Mailing Address - Country:US
Mailing Address - Phone:330-257-4338
Mailing Address - Fax:
Practice Address - Street 1:1390 S ARCH AVE
Practice Address - Street 2:
Practice Address - City:ALLIANCE
Practice Address - State:OH
Practice Address - Zip Code:44601-4111
Practice Address - Country:US
Practice Address - Phone:330-821-3961
Practice Address - Fax:330-821-0232
Is Sole Proprietor?:No
Enumeration Date:2020-01-04
Last Update Date:2020-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.023722363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health