1033102108 NPI number — MS. PATRICIA ANN MCKEE RN, MN, CPNP

Table of content: MS. PATRICIA ANN MCKEE RN, MN, CPNP (NPI 1033102108)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033102108 NPI number — MS. PATRICIA ANN MCKEE RN, MN, CPNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCKEE
Provider First Name:
PATRICIA
Provider Middle Name:
ANN
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
RN, MN, CPNP
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:
1033102108
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10842 MATHER AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SUNLAND
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91040-2562
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
858-344-3347
Provider Business Mailing Address Fax Number:
323-668-4029

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4650 W SUNSET BLVD
Provider Second Line Business Practice Location Address:
MS #96
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90027-6062
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-669-4543
Provider Business Practice Location Address Fax Number:
323-668-4029
Provider Enumeration Date:
08/24/2005

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: 363LP0200X , with the licence number:  177591 NP1151 , 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)





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