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NPI Code Detail

MEDICARE: AUDRA NICOLE MCKINNEY

MEDICARE: AUDRA NICOLE MCKINNEY
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
13747P1801XPersonal Care Attendant

General Provider Information

NPI Number : 1194689794
Entity Type Code : Individual
Provider Name (Legal Business Name) : AUDRA NICOLE MCKINNEY
Provider Business Mailing Address
First Line : 188 VALLEY ST
Second Line :
City : SALEM
State : WV
Zip : 26426-1025
Country : US
Telephone Number : 304-566-2331
Fax Number :
Provider Business Practice Location Address
First Line : 500 W MAIN ST
Second Line :
City : CLARKSBURG
State : WV
Zip : 26301-2819
Country : US
Telephone Number : 304-623-6795
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/10/2025
Last Update Date : 12/10/2025

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Directions to “ AUDRA NICOLE MCKINNEY ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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