Provider Demographics
NPI:1538652086
Name:MCGEE, MARKITA DARLENE (LVN)
Entity Type:Individual
Prefix:
First Name:MARKITA
Middle Name:DARLENE
Last Name:MCGEE
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5318 LAUREL CANYON BLVD STE 105
Mailing Address - Street 2:
Mailing Address - City:VALLEY VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91607-4932
Mailing Address - Country:US
Mailing Address - Phone:800-831-0530
Mailing Address - Fax:
Practice Address - Street 1:5318 LAUREL CANYON BLVD STE 105
Practice Address - Street 2:
Practice Address - City:VALLEY VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91607-4932
Practice Address - Country:US
Practice Address - Phone:800-831-0530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-10
Last Update Date:2018-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN228045164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse