Provider Demographics
NPI:1336467976
Name:MCKEE, KRISTIN CORY (DO)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:CORY
Last Name:MCKEE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:655 W 8TH ST # C506
Mailing Address - Street 2:CLINICAL CENTER, 1ST FLOOR
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32209-6511
Mailing Address - Country:US
Mailing Address - Phone:904-244-3817
Mailing Address - Fax:904-244-4077
Practice Address - Street 1:655 W 8TH ST # C506
Practice Address - Street 2:CLINICAL CENTER, 1ST FLOOR
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32209-6511
Practice Address - Country:US
Practice Address - Phone:904-244-3817
Practice Address - Fax:904-244-4077
Is Sole Proprietor?:No
Enumeration Date:2010-05-06
Last Update Date:2013-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLUO2389207P00000X
FLOS12083207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL008928700Medicaid
FL14PK6OtherBCBS
FL008928700Medicaid