Provider Demographics
NPI:1235740796
Name:MCKINNEY, NIULQUIE
Entity Type:Individual
Prefix:MRS
First Name:NIULQUIE
Middle Name:
Last Name:MCKINNEY
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 1:97 SMITH ST
Mailing Address - Street 2:
Mailing Address - City:IRVINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07111-2022
Mailing Address - Country:US
Mailing Address - Phone:862-220-6506
Mailing Address - Fax:
Practice Address - Street 1:2923 - 2925 E THOMPSON ST UNIT #2 -244
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:NJ
Practice Address - Zip Code:19134-1913
Practice Address - Country:US
Practice Address - Phone:862-800-7447
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-10
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175M00000XOther Service ProvidersMidwife, Lay
No174H00000XOther Service ProvidersHealth Educator
No174N00000XOther Service ProvidersLactation Consultant, Non-RN
No175T00000XOther Service ProvidersPeer Specialist
No176B00000XOther Service ProvidersMidwife
No172V00000XOther Service ProvidersCommunity Health Worker
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No347C00000XTransportation ServicesPrivate Vehicle
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No374J00000XNursing Service Related ProvidersDoula