MEDICARE: DOROTHY YVONNE MCKEE APRN

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	AP127110	TX
2	363LF0000X	Family Nurse Practitioner	M0137300	OK

General Provider Information

NPI Number	:	1871991430
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOROTHY YVONNE MCKEE APRN

Provider Business Mailing Address
First Line	:	PO BOX 26666
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87125-6666
Country	:	US
Telephone Number	:	505-923-5361
Fax Number	:

Provider Business Practice Location Address
First Line	:	1400 CHAMA AVE
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87505-3372
Country	:	US
Telephone Number	:	505-988-2211
Fax Number	:

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

Provider Enumeration Date	:	12/15/2014
Last Update Date	:	11/19/2024

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