Provider Demographics
NPI:1073913315
Name:MCKEEVER, ANGELA (RN)
Entity Type:Individual
Prefix:MISS
First Name:ANGELA
Middle Name:
Last Name:MCKEEVER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 W FRONT ST
Mailing Address - Street 2:
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-2801
Mailing Address - Country:US
Mailing Address - Phone:406-497-5074
Mailing Address - Fax:
Practice Address - Street 1:25 W FRONT ST
Practice Address - Street 2:
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-2801
Practice Address - Country:US
Practice Address - Phone:406-497-5074
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-22
Last Update Date:2014-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTNUR-RN-LIC-47952163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse