National Provider Identifier
Jennifer Michele McKeon, PHD, ATC, CSCS
Jennifer Michele McKeon, PHD, ATC, CSCS is listed in the NPPES registry with a primary specialty of Athletic Trainer in Ithaca, NY and a listed phone number of (607) 274-1456.
Profile Overview
- NPI
- 1215550827
- Provider Type
- Individual
- Primary Specialty
- Athletic Trainer
- Enumeration Date
- May 19, 2020
- Last Updated
- May 19, 2020
Practice Location
- 953 Danby Road
- Hill Center, Room G65
- Ithaca, NY 14850-7002
Phone: (607) 274-1456
Specialties
- Athletic Trainer (2255A2300X)
Full Record
- NPI
- 1215550827
- Entity Type
- Individual
- Last Name
- McKeon
- First Name
- Jennifer
- Middle Name
- Michele
- Name Prefix
- Dr.
- Credential
- PHD, ATC, CSCS
- Provider Other Last Name
- Medina
- Provider Other First Name
- Jennifer
- Provider Other Middle Name
- Michele
- Provider Other Credential Text
- MS, ATC, CSCS
- Provider Other Last Name Type Code
- 1
- Mailing Street Address
- 953 Danby Road
- Mailing Address Line 2
- Hill Center, Room G65
- Mailing City
- Ithaca
- Mailing State
- NY
- Mailing ZIP Code
- 14850-7002
- Mailing Country
- US
- Mailing Phone
- (607) 274-1456
- Practice Street Address
- 953 Danby Road
- Practice Address Line 2
- Hill Center, Room G65
- Practice City
- Ithaca
- Practice State
- NY
- Practice ZIP Code
- 14850-7002
- Practice Country
- US
- Practice Phone
- (607) 274-1456
- Enumeration Date
- May 19, 2020
- Last Updated
- May 19, 2020
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- May 19, 2020
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Athletic Trainer (2255A2300X)