Healthcare Provider Details

I. General information

NPI: 1962122663
Provider Name (Legal Business Name): ALYSSA MCKEE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2022
Last Update Date: 09/01/2022
Certification Date: 05/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1213 E CLAY ST
RICHMOND VA
23298-5071
US

IV. Provider business mailing address

9313 CROFT CROSSING CT
NORTH CHESTERFIELD VA
23237-3197
US

V. Phone/Fax

Practice location:
  • Phone: 804-818-9000
  • Fax:
Mailing address:
  • Phone: 804-718-1546
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License Number0024185032
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: