Provider Demographics
NPI:1417625682
Name:MCKAY, KYLEE J (NP)
Entity Type:Individual
Prefix:MRS
First Name:KYLEE
Middle Name:J
Last Name:MCKAY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MISS
Other - First Name:KYLEE
Other - Middle Name:J
Other - Last Name:KARAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1375 W GREEN ST STE 3
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:MI
Mailing Address - Zip Code:49058-1708
Mailing Address - Country:US
Mailing Address - Phone:269-818-0700
Mailing Address - Fax:269-818-0044
Practice Address - Street 1:1375 W GREEN ST STE 3
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:MI
Practice Address - Zip Code:49058-1708
Practice Address - Country:US
Practice Address - Phone:269-818-0700
Practice Address - Fax:269-818-0044
Is Sole Proprietor?:No
Enumeration Date:2021-09-02
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704317436363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics