Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MT210503 | PA |
Y | 2084N0402X | Child Neurologist | MD472970 | PA |
NPI | 1376992156 |
---|---|
Provider Name | Jillian Lee Mckee |
First Address | Philadelphia, PA 19104-4319 |
Second Address | Philadelphia, PA 19104-4319 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2016 |
Last Update Date | 13/07/2021 |