Provider Demographics
NPI:1679786032
Name:MCKINNEY, JUANKEE JEVONNE (PHD)
Entity type:Individual
Prefix:DR
First Name:JUANKEE
Middle Name:JEVONNE
Last Name:MCKINNEY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5714 BARTMER AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63112-2811
Mailing Address - Country:US
Mailing Address - Phone:314-454-1267
Mailing Address - Fax:314-454-1267
Practice Address - Street 1:4144 LINDELL BLVD
Practice Address - Street 2:SUITE 501
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63108-2927
Practice Address - Country:US
Practice Address - Phone:314-531-4743
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO01734174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist