Healthcare Provider Details

I. General information

NPI: 1003093170
Provider Name (Legal Business Name): MS. KILA E MCGHEE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KILA BROUN

II. Dates (important events)

Enumeration Date: 01/30/2008
Last Update Date: 01/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1108 TOD AVE NW
WARREN OH
44485
US

IV. Provider business mailing address

1108 TOD AVE NW
WARREN OH
44485
US

V. Phone/Fax

Practice location:
  • Phone: 330-501-9584
  • Fax: 330-980-9439
Mailing address:
  • Phone: 330-501-9584
  • Fax: 330-980-9439

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: