Provider Demographics
NPI:1568182129
Name:MCKINNEY, OLIVIA MAE
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:MAE
Last Name:MCKINNEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5922 ANTIGUA DR
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93313-5131
Mailing Address - Country:US
Mailing Address - Phone:661-497-4111
Mailing Address - Fax:
Practice Address - Street 1:5922 ANTIGUA DR
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93313-5131
Practice Address - Country:US
Practice Address - Phone:661-497-4111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-01
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider