Provider Demographics
NPI:1346529245
Name:MCKINLEY, DARA LEE (FNP)
Entity Type:Individual
Prefix:
First Name:DARA
Middle Name:LEE
Last Name:MCKINLEY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 INDEPENDENCE CIR
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95973-0258
Mailing Address - Country:US
Mailing Address - Phone:530-899-2107
Mailing Address - Fax:530-899-0142
Practice Address - Street 1:100 INDEPENDENCE CIR
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95973-0258
Practice Address - Country:US
Practice Address - Phone:530-899-2107
Practice Address - Fax:530-899-0142
Is Sole Proprietor?:No
Enumeration Date:2011-08-09
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP20830363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily