Provider Demographics
NPI:1528847183
Name:MCKINNEY, JOSCELYN
Entity type:Individual
Prefix:
First Name:JOSCELYN
Middle Name:
Last Name:MCKINNEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29365 HICKORY RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601-8657
Mailing Address - Country:US
Mailing Address - Phone:410-476-7826
Mailing Address - Fax:
Practice Address - Street 1:29276 ERICKSON DR
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-8613
Practice Address - Country:US
Practice Address - Phone:443-205-4757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-25
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist