Provider Demographics
NPI:1073393971
Name:MCKEE, CAROLINE GRAY
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:GRAY
Last Name:MCKEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7214 LIGHTHOUSE WAY
Mailing Address - Street 2:
Mailing Address - City:PERRYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43551-7053
Mailing Address - Country:US
Mailing Address - Phone:225-892-6260
Mailing Address - Fax:
Practice Address - Street 1:2221 MADISON AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43604-7132
Practice Address - Country:US
Practice Address - Phone:225-892-6260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-29
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant