Healthcare Provider Details

I. General information

NPI: 1033102108
Provider Name (Legal Business Name): PATRICIA ANN MCKEE RN, MN, CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/24/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4650 W SUNSET BLVD MS #96
LOS ANGELES CA
90027-6062
US

IV. Provider business mailing address

10842 MATHER AVE
SUNLAND CA
91040-2562
US

V. Phone/Fax

Practice location:
  • Phone: 323-669-4543
  • Fax: 323-668-4029
Mailing address:
  • Phone: 858-344-3347
  • Fax: 323-668-4029

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number177591 NP1151
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: