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General NPI Number Information
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NPI Number | 1205623170
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Entity Type | Individual
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Provider Name | ELIZABETH MCKEON
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Gender | Female
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Dates
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Enumeration Date | 04/23/2025
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Last Update Date | 05/12/2026
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Provider Practice Location Address
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Address Line | 633 HIGHWAY 441 S
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City | CLAYTON
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State | GA
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Zip | 30525-5425
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Country | US
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Telephone | 706-212-0349
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Fax | 706-212-0349
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Provider Business Mailing Address
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Address Line | 168 ROGERS ST STE F
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City | BLAIRSVILLE
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State | GA
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Zip | 30512-3621
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Country | US
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Telephone | 678-349-4911
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN-NP273584
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License Number State | GA
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