Provider Demographics
NPI:1407913817
Name:MCKINNEY, CATHY HILL (APN)
Entity Type:Individual
Prefix:MS
First Name:CATHY
Middle Name:HILL
Last Name:MCKINNEY
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1720 E REELFOOT AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:UNION CITY
Mailing Address - State:TN
Mailing Address - Zip Code:38261-6047
Mailing Address - Country:US
Mailing Address - Phone:731-885-6600
Mailing Address - Fax:731-885-9239
Practice Address - Street 1:1720 E REELFOOT AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:UNION CITY
Practice Address - State:TN
Practice Address - Zip Code:38261-6047
Practice Address - Country:US
Practice Address - Phone:731-885-6600
Practice Address - Fax:731-885-9239
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN 5298363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ002319Medicaid
TN6040219OtherBLUE CROSS BLUE SHIELD
TN448944Medicare PIN