MEDICARE: KATHERINE MCKEEGAN

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	106S00000X	Behavior Technician
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1679073357
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE MCKEEGAN

Provider Business Mailing Address
First Line	:	17360 TOAKOANA DR
Second Line	:
City	:	EAGLE RIVER
State	:	AK
Zip	:	99577-8510
Country	:	US
Telephone Number	:	858-829-7910
Fax Number	:

Provider Business Practice Location Address
First Line	:	3340 PROVIDENCE DR STE A-452
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-4691
Country	:	US
Telephone Number	:	907-562-2120
Fax Number	:

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

Provider Enumeration Date	:	02/19/2018
Last Update Date	:	03/12/2026

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Directions to “ KATHERINE MCKEEGAN ” Practice Location

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