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General NPI Number Information
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NPI Number | 1285989152
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Entity Type | Individual
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Provider Name | ANGELA G MCKINNEY NP-C
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Gender | Female
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Dates
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Enumeration Date | 07/17/2012
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Last Update Date | 01/09/2025
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Provider Practice Location Address
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Address Line | 904 HARRISON ST
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City | PRINCETON
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State | WV
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Zip | 24740-3011
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Country | US
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Telephone | 304-431-7100
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Fax | 304-431-7112
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Provider Business Mailing Address
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Address Line | PO BOX 507 RR 103 SUPPLY STREET
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City | GARY
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State | WV
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Zip | 24836-0507
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Country | US
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Telephone | 304-448-2101
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Fax | 304-448-3217
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 51212
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License Number State | WV
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