MEDICARE: MRS. JENNIFER ANGELL MCKEE MS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1104229939
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JENNIFER ANGELL MCKEE MS

Provider Business Mailing Address
First Line	:	3319 RIDGEVIEW DR
Second Line	:
City	:	GREEN COVE SPRINGS
State	:	FL
Zip	:	32043-7058
Country	:	US
Telephone Number	:	281-725-2020
Fax Number	:

Provider Business Practice Location Address
First Line	:	3319 RIDGEVIEW DR
Second Line	:
City	:	GREEN COVE SPRINGS
State	:	FL
Zip	:	32043-7058
Country	:	US
Telephone Number	:	281-725-2020
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/07/2014
Last Update Date	:	10/07/2014

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