Provider Demographics
NPI:1740745702
Name:MACKEY, MONICA LYNETTE (NP)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:LYNETTE
Last Name:MACKEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8568 ELMCREEK CT
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-8023
Mailing Address - Country:US
Mailing Address - Phone:512-517-0362
Mailing Address - Fax:
Practice Address - Street 1:276 BIELBY RD
Practice Address - Street 2:
Practice Address - City:LAWRENCEBURG
Practice Address - State:IN
Practice Address - Zip Code:47025-2787
Practice Address - Country:US
Practice Address - Phone:812-532-8437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-04
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3013406363LF0000X
OHAPRN.CNP.024697363LF0000X
TXAP140249363LF0000X
IN71010256A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily