Provider Demographics
NPI:1942518477
Name:MCKEON, DENNIS PETER (RN)
Entity Type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:PETER
Last Name:MCKEON
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9601 ASHTON MANOR WAY
Mailing Address - Street 2:
Mailing Address - City:WAXHAW
Mailing Address - State:NC
Mailing Address - Zip Code:28173-7874
Mailing Address - Country:US
Mailing Address - Phone:704-256-4467
Mailing Address - Fax:
Practice Address - Street 1:4293 HIGHWAY 24 27 E STE D
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:NC
Practice Address - Zip Code:28107-8500
Practice Address - Country:US
Practice Address - Phone:704-888-2380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-17
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC219036163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health