Provider Demographics
NPI:1942900352
Name:MCKEEGAN, PATRICK JOHN (FNP)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:JOHN
Last Name:MCKEEGAN
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 N BRAEBURN PL
Mailing Address - Street 2:
Mailing Address - City:STAUNTON
Mailing Address - State:VA
Mailing Address - Zip Code:24401-9008
Mailing Address - Country:US
Mailing Address - Phone:540-290-5772
Mailing Address - Fax:
Practice Address - Street 1:810 N BRAEBURN PL
Practice Address - Street 2:
Practice Address - City:STAUNTON
Practice Address - State:VA
Practice Address - Zip Code:24401-9008
Practice Address - Country:US
Practice Address - Phone:540-290-5772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024186533363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily