Provider Demographics
NPI:1235153610
Name:REID-MCKEE, CATHERINE N (NP)
Entity Type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:N
Last Name:REID-MCKEE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 VICTORIA DR
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86305-5262
Mailing Address - Country:US
Mailing Address - Phone:928-541-1056
Mailing Address - Fax:928-771-3369
Practice Address - Street 1:3212 N WINDSONG DR STE 200
Practice Address - Street 2:
Practice Address - City:PRESCOTT VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86314-2288
Practice Address - Country:US
Practice Address - Phone:928-771-3377
Practice Address - Fax:928-771-3379
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN074942363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ114786Medicaid
AZP85103Medicare UPIN
AZ114786Medicaid