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NPI Code Detail

MEDICARE: MRS. OLVIA A MCKINNEY NP

MEDICARE: MRS. OLVIA A MCKINNEY NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse28174669AIN
2363L00000XNurse Practitioner71004839AIN

General Provider Information

NPI Number : 1184922395
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. OLVIA A MCKINNEY NP
Provider Business Mailing Address
First Line : 7830 JOHNSON RD
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46250-2075
Country : US
Telephone Number : 317-396-0683
Fax Number : 317-396-0687
Provider Business Practice Location Address
First Line : 7830 JOHNSON RD
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46250-2075
Country : US
Telephone Number : 317-396-0683
Fax Number : 317-396-0687
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/11/2011
Last Update Date : 07/04/2014

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Directions to “ MRS. OLVIA A MCKINNEY NP” Practice Location

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