Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 025909 | OH |
N | 363LG0600X | Nurse Practitioner - Gerontology | 025909 | OH |
NPI | 1023656642 |
---|---|
Provider Name | Ms. Nicole Lynn Mckee |
First Address | Waverly, OH 45690-9066 |
Second Address | Jackson, OH 45640-1144 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2019 |
Last Update Date | 13/12/2019 |