Healthcare Provider Details

I. General information

NPI: 1679088116
Provider Name (Legal Business Name): KELLI PATRICIA MCKAY PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2017
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1536 PROFESSIONAL PKWY
AUBURN AL
36830-2857
US

IV. Provider business mailing address

1536 PROFESSIONAL PKWY
AUBURN AL
36830-2857
US

V. Phone/Fax

Practice location:
  • Phone: 248-977-0627
  • Fax: 248-955-9228
Mailing address:
  • Phone: 248-977-0627
  • Fax: 248-955-9228

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberCO00005217
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number5601013450
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: