MEDICARE: BRIAN E MCKAY NURSE PRACTITIONER

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	363LF0000X	Family Nurse Practitioner	4014460	KY

General Provider Information

NPI Number	:	1821971409
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN E MCKAY NURSE PRACTITIONER

Provider Business Mailing Address
First Line	:	2024 INDIGO DR
Second Line	:
City	:	RICHMOND
State	:	KY
Zip	:	40475-8227
Country	:	US
Telephone Number	:	907-406-4296
Fax Number	:

Provider Business Practice Location Address
First Line	:	2024 INDIGO DR
Second Line	:
City	:	RICHMOND
State	:	KY
Zip	:	40475-8227
Country	:	US
Telephone Number	:	907-406-4296
Fax Number	:

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

Provider Enumeration Date	:	07/30/2025
Last Update Date	:	07/30/2025

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