1336338292 NPI number — PATRICIA LOUISE MCKINNEY APN

Table of content: PATRICIA LOUISE MCKINNEY APN (NPI 1336338292)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336338292 NPI number — PATRICIA LOUISE MCKINNEY APN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCKINNEY
Provider First Name:
PATRICIA
Provider Middle Name:
LOUISE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
APN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1336338292
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/17/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
WIESBADEN ARMY HEALTH CLINIC
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CMR 467 UNIT 29623
Provider Business Mailing Address State Name:
APO, AE
Provider Business Mailing Address Postal Code:
09096
Provider Business Mailing Address Country Code:
DE
Provider Business Mailing Address Telephone Number:
496117051750
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
WIESBADEN ARMY HEALTH CLINIC
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
APO, AE
Provider Business Practice Location Address State Name:
WIESBADEN
Provider Business Practice Location Address Postal Code:
09096
Provider Business Practice Location Address Country Code:
DE
Provider Business Practice Location Address Telephone Number:
491622707776
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/17/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163WA2000X , with the licence number:  442200 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 163WC1500X , with the licence number: 442200 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 442200 . This is a "RN LICENSE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".