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NPI Code Detail

MEDICARE: MS. KELLI R MCKEE PA-C

MEDICARE: MS. KELLI R MCKEE PA-C
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
1363AS0400XSurgical Physician Assistant481WY
2363AS0400XSurgical Physician Assistant1735CO
3363A00000XPhysician Assistant1735CO

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P01481660OTHERCORR MEDICARE
3P01492742OTHERWYRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1558344812
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KELLI R MCKEE PA-C
Provider Business Mailing Address
First Line : 2550 N THUNDERBIRD CIR STE 303
Second Line :
City : MESA
State : AZ
Zip : 85215-1219
Country : US
Telephone Number : 480-455-4932
Fax Number : 480-776-0025
Provider Business Practice Location Address
First Line : 1683 MAIN ST STE B
Second Line :
City : WINDSOR
State : CO
Zip : 80550-7921
Country : US
Telephone Number : 970-400-7618
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/21/2005
Last Update Date : 07/10/2025

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