Provider Demographics
NPI:1033102108
Name:MCKEE, PATRICIA ANN (RN, MN, CPNP)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:ANN
Last Name:MCKEE
Suffix:
Gender:F
Credentials:RN, MN, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10842 MATHER AVE
Mailing Address - Street 2:
Mailing Address - City:SUNLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91040-2562
Mailing Address - Country:US
Mailing Address - Phone:858-344-3347
Mailing Address - Fax:323-668-4029
Practice Address - Street 1:4650 W SUNSET BLVD
Practice Address - Street 2:MS #96
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-6062
Practice Address - Country:US
Practice Address - Phone:323-669-4543
Practice Address - Fax:323-668-4029
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA177591 NP1151363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics