Healthcare Provider Details

I. General information

NPI: 1033533427
Provider Name (Legal Business Name): KRISTA MCKEE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2014
Last Update Date: 05/21/2021
Certification Date: 05/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 EAST MICHIGAN AVE MERCY HOSPITAL- GRAYLING
GRAYLING MI
49738
US

IV. Provider business mailing address

10 COMMERCE DRIVE
NEW ROCHELLE NY
10801
US

V. Phone/Fax

Practice location:
  • Phone: 989-348-5461
  • Fax:
Mailing address:
  • Phone: 914-637-2063
  • Fax: 914-365-6307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberL2445534
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: