Provider Demographics
NPI:1114155165
Name:MCKEEFERY, BARBARA ANN (ABOC/FNAO)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:ANN
Last Name:MCKEEFERY
Suffix:
Gender:F
Credentials:ABOC/FNAO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:234 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-2005
Mailing Address - Country:US
Mailing Address - Phone:410-268-6246
Mailing Address - Fax:410-268-6244
Practice Address - Street 1:234 MAIN ST
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-2005
Practice Address - Country:US
Practice Address - Phone:410-268-6246
Practice Address - Fax:410-268-6244
Is Sole Proprietor?:No
Enumeration Date:2009-06-29
Last Update Date:2009-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD156FX1800X156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician