Healthcare Provider Details

I. General information

NPI: 1053728923
Provider Name (Legal Business Name): HARMONY MCKAY FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2014
Last Update Date: 01/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 E VAN RIPER RD
FOWLERVILLE MI
48836-7947
US

IV. Provider business mailing address

36123 SCHOOLCRAFT RD
LIVONIA MI
48150-1216
US

V. Phone/Fax

Practice location:
  • Phone: 517-223-7900
  • Fax:
Mailing address:
  • Phone: 734-793-6140
  • Fax: 865-560-8948

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704216643
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: