Provider Demographics
NPI:1114779600
Name:MCKANE, KECIA KAY
Entity Type:Individual
Prefix:MRS
First Name:KECIA
Middle Name:KAY
Last Name:MCKANE
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 1:2942 RAE LYNN LN
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48381-2542
Mailing Address - Country:US
Mailing Address - Phone:248-396-0384
Mailing Address - Fax:
Practice Address - Street 1:2942 RAE LYNN LN
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:MI
Practice Address - Zip Code:48381-2542
Practice Address - Country:US
Practice Address - Phone:248-396-0384
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-05
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker