Provider Demographics
NPI:1386645745
Name:MCKEE, CHERYL L (PA-C)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:L
Last Name:MCKEE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4465 WHITE BEAR PARKWAY
Mailing Address - Street 2:
Mailing Address - City:WHITE BEAR LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55110
Mailing Address - Country:US
Mailing Address - Phone:651-653-0062
Mailing Address - Fax:651-653-0288
Practice Address - Street 1:4465 WHITE BEAR PARKWAY
Practice Address - Street 2:
Practice Address - City:WHITE BEAR LAKE
Practice Address - State:MN
Practice Address - Zip Code:55110
Practice Address - Country:US
Practice Address - Phone:651-653-0062
Practice Address - Fax:651-653-0288
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN41 1853319363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q31978Medicare UPIN