Provider Demographics
NPI:1710449467
Name:MCGRADY, KERI SAWYERS (RN)
Entity Type:Individual
Prefix:
First Name:KERI
Middle Name:SAWYERS
Last Name:MCGRADY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:199 HOSPITAL DR STE 7
Mailing Address - Street 2:
Mailing Address - City:GALAX
Mailing Address - State:VA
Mailing Address - Zip Code:24333-2453
Mailing Address - Country:US
Mailing Address - Phone:276-236-5181
Mailing Address - Fax:
Practice Address - Street 1:199 HOSPITAL DR STE 7
Practice Address - Street 2:
Practice Address - City:GALAX
Practice Address - State:VA
Practice Address - Zip Code:24333-2453
Practice Address - Country:US
Practice Address - Phone:276-236-5181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-02
Last Update Date:2019-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001242540163W00000X
VA0024177681363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse