Provider Demographics
NPI:1477597409
Name:MCKAY, JUDITH H (CRNA)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:H
Last Name:MCKAY
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1116
Mailing Address - Street 2:
Mailing Address - City:BREVARD
Mailing Address - State:NC
Mailing Address - Zip Code:28712-1116
Mailing Address - Country:US
Mailing Address - Phone:828-885-7137
Mailing Address - Fax:
Practice Address - Street 1:260 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:BREVARD
Practice Address - State:NC
Practice Address - Zip Code:28712-1116
Practice Address - Country:US
Practice Address - Phone:828-884-9111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC071138367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2616827Medicare ID - Type UnspecifiedCRNA