Provider Demographics
NPI:1275873523
Name:MCKEE, CARISSA (DC)
Entity Type:Individual
Prefix:DR
First Name:CARISSA
Middle Name:
Last Name:MCKEE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11048 BAYMEADOWS RD
Mailing Address - Street 2:UNIT 2
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-9699
Mailing Address - Country:US
Mailing Address - Phone:904-733-7393
Mailing Address - Fax:
Practice Address - Street 1:11048 BAYMEADOWS RD
Practice Address - Street 2:UNIT 2
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-9699
Practice Address - Country:US
Practice Address - Phone:904-733-7393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-24
Last Update Date:2013-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL10681111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor