Provider Demographics
NPI:1043903958
Name:MCKAY, KELLI C (CNM)
Entity Type:Individual
Prefix:
First Name:KELLI
Middle Name:C
Last Name:MCKAY
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 BEAR HILL RD
Mailing Address - Street 2:
Mailing Address - City:CHICHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03258-6201
Mailing Address - Country:US
Mailing Address - Phone:478-288-7929
Mailing Address - Fax:
Practice Address - Street 1:255 LOW ST STE 101
Practice Address - Street 2:
Practice Address - City:NEWBURYPORT
Practice Address - State:MA
Practice Address - Zip Code:01950-3596
Practice Address - Country:US
Practice Address - Phone:978-556-0100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-29
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2357108367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife