Provider Demographics
NPI:1124772546
Name:MCKAY, KAITLYNN ANNE (FNP)
Entity type:Individual
Prefix:MRS
First Name:KAITLYNN
Middle Name:ANNE
Last Name:MCKAY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2107 S OUTER BELT RD
Mailing Address - Street 2:
Mailing Address - City:OAK GROVE
Mailing Address - State:MO
Mailing Address - Zip Code:64075-9600
Mailing Address - Country:US
Mailing Address - Phone:816-519-5335
Mailing Address - Fax:
Practice Address - Street 1:2107 S OUTER BELT RD
Practice Address - Street 2:
Practice Address - City:OAK GROVE
Practice Address - State:MO
Practice Address - Zip Code:64075-9600
Practice Address - Country:US
Practice Address - Phone:816-519-5335
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-04
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA181047363LF0000X
KS80983363LF0000X
MI4074417976363LF0000X
WI16187-33363LF0000X
OH0037277363LF0000X
MN11965363LF0000X
NE115471363LF0000X
IN71015761A363LF0000X
IL209.031352363LF0000X
MO2021047826363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily