MEDICARE: JANE E MCKEE MSN

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	163W00000X	Registered Nurse	RN00126540	WA
2	363LF0000X	Family Nurse Practitioner	AP30005569	WA
3	363LF0000X	Family Nurse Practitioner	AP2345	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386640639
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANE E MCKEE MSN

Provider Business Mailing Address
First Line	:	17917 VASHON HWY SW
Second Line	:
City	:	VASHON
State	:	WA
Zip	:	98070-5204
Country	:	US
Telephone Number	:	206-463-2800
Fax Number	:

Provider Business Practice Location Address
First Line	:	17917 VASHON HWY SW
Second Line	:
City	:	VASHON
State	:	WA
Zip	:	98070-5204
Country	:	US
Telephone Number	:	206-463-2800
Fax Number	:

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

Provider Enumeration Date	:	06/22/2005
Last Update Date	:	04/13/2009

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