MEDICARE: DEANNA ROARK MCKEE NP

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	363LA2100X	Acute Care Nurse Practitioner	TAP002935	LA
2	363LA2100X	Acute Care Nurse Practitioner	AP07044	LA

General Provider Information

NPI Number	:	1215282215
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEANNA ROARK MCKEE NP

Provider Business Mailing Address
First Line	:	102 THOMAS RD.
Second Line	:	STE 107
City	:	WEST MONROE
State	:	LA
Zip	:	71291
Country	:	US
Telephone Number	:	318-322-7726
Fax Number	:	318-322-2614

Provider Business Practice Location Address
First Line	:	2503 BROADMOOR BLVD
Second Line	:
City	:	MONROE
State	:	LA
Zip	:	71201-2987
Country	:	US
Telephone Number	:	318-322-7726
Fax Number	:	318-322-2614

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

Provider Enumeration Date	:	07/17/2012
Last Update Date	:	11/22/2024

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