Healthcare Provider Details

I. General information

NPI: 1871991430
Provider Name (Legal Business Name): DOROTHY YVONNE MCKEE APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DOROTHY YVONNE HOOTEN APRN

II. Dates (important events)

Enumeration Date: 12/15/2014
Last Update Date: 11/19/2024
Certification Date: 11/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 CHAMA AVE
SANTA FE NM
87505-3372
US

IV. Provider business mailing address

PO BOX 26666
ALBUQUERQUE NM
87125-6666
US

V. Phone/Fax

Practice location:
  • Phone: 505-988-2211
  • Fax:
Mailing address:
  • Phone: 505-923-5361
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP127110
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberM0137300
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: