MEDICARE: ANDREA N. MCKAY APRN.CNP

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
1	363LF0000X	Family Nurse Practitioner	APRN.CNP.023052	OH

General Provider Information

NPI Number	:	1376039388
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA N. MCKAY APRN.CNP

Provider Business Mailing Address
First Line	:	1975 MIAMISBURG CENTERVILLE RD
Second Line	:
City	:	CENTERVILLE
State	:	OH
Zip	:	45459-3811
Country	:	US
Telephone Number	:	937-439-6186
Fax Number	:	937-439-6189

Provider Business Practice Location Address
First Line	:	101 E ALEX BELL RD STE 190
Second Line	:
City	:	CENTERVILLE
State	:	OH
Zip	:	45459-2752
Country	:	US
Telephone Number	:	937-425-4030
Fax Number	:	937-425-4039

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/03/2018
Last Update Date	:	11/17/2025

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