Provider Demographics
NPI:1528585601
Name:THE CONCIERGE NP, LLC
Entity Type:Organization
Organization Name:THE CONCIERGE NP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NP/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KEISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKINSEY
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:214-903-8070
Mailing Address - Street 1:1311 FERRIS AVE STE A
Mailing Address - Street 2:
Mailing Address - City:WAXAHACHIE
Mailing Address - State:TX
Mailing Address - Zip Code:75165-1861
Mailing Address - Country:US
Mailing Address - Phone:214-903-8070
Mailing Address - Fax:
Practice Address - Street 1:1311 FERRIS AVE STE A
Practice Address - Street 2:
Practice Address - City:WAXAHACHIE
Practice Address - State:TX
Practice Address - Zip Code:75165-1861
Practice Address - Country:US
Practice Address - Phone:214-903-8070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-29
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP131334261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service