Provider Demographics
NPI:1982259024
Name:MCKERNAN, MARGARET ROSE (PA)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:ROSE
Last Name:MCKERNAN
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:5800 LANDERBROOK DR
Mailing Address - Street 2:STE 100
Mailing Address - City:MAYFIELD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44124-6510
Mailing Address - Country:US
Mailing Address - Phone:724-591-6720
Mailing Address - Fax:
Practice Address - Street 1:6820 RIDGE RD STE 204
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44129-5647
Practice Address - Country:US
Practice Address - Phone:440-443-0423
Practice Address - Fax:440-443-0414
Is Sole Proprietor?:No
Enumeration Date:2019-08-06
Last Update Date:2022-01-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH50.006265RX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant