Provider Demographics
NPI:1134517303
Name:MROSKEY, MEKENNA RENEE (NP)
Entity type:Individual
Prefix:
First Name:MEKENNA
Middle Name:RENEE
Last Name:MROSKEY
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 LENNON LN
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-2443
Mailing Address - Country:US
Mailing Address - Phone:925-433-8786
Mailing Address - Fax:925-433-8788
Practice Address - Street 1:575 LENNON LN
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-2443
Practice Address - Country:US
Practice Address - Phone:925-433-8786
Practice Address - Fax:925-433-8788
Is Sole Proprietor?:No
Enumeration Date:2014-12-22
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95002182363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner