Provider Demographics
NPI:1194214643
Name:MCKAY, NAN
Entity Type:Individual
Prefix:
First Name:NAN
Middle Name:
Last Name:MCKAY
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 1:1994 CROMWELL BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-1418
Mailing Address - Country:US
Mailing Address - Phone:410-825-2020
Mailing Address - Fax:410-321-1466
Practice Address - Street 1:1994 CROMWELL BRIDGE RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21234-1418
Practice Address - Country:US
Practice Address - Phone:410-825-2020
Practice Address - Fax:410-321-1466
Is Sole Proprietor?:No
Enumeration Date:2018-05-09
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes226000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreational Therapist Assistant