Provider Demographics
NPI:1790019818
Name:MCKEE, MEREDITH J (NP)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:J
Last Name:MCKEE
Suffix:
Gender:F
Credentials:NP
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Other - Credentials:
Mailing Address - Street 1:4110 BRIARGATE PKWY
Mailing Address - Street 2:SUITE 465
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-7835
Mailing Address - Country:US
Mailing Address - Phone:719-477-0211
Mailing Address - Fax:719-477-0501
Practice Address - Street 1:4110 BRIARGATE PKWY
Practice Address - Street 2:SUITE 465
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-7835
Practice Address - Country:US
Practice Address - Phone:719-477-0211
Practice Address - Fax:719-477-0501
Is Sole Proprietor?:No
Enumeration Date:2009-09-22
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0010126363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO59100567Medicaid
COCOA109730Medicare PIN