Provider Demographics
NPI:1093304065
Name:MCNAB, KALEY JOY (FNP-C)
Entity Type:Individual
Prefix:
First Name:KALEY
Middle Name:JOY
Last Name:MCNAB
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1120 10TH ST
Mailing Address - Street 2:
Mailing Address - City:BREWSTER
Mailing Address - State:MN
Mailing Address - Zip Code:56119-1901
Mailing Address - Country:US
Mailing Address - Phone:507-360-5620
Mailing Address - Fax:
Practice Address - Street 1:1430 NORTH HWY
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MN
Practice Address - Zip Code:56143-1093
Practice Address - Country:US
Practice Address - Phone:507-847-2420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-14
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7943363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily