Provider Demographics
NPI:1336599802
Name:MCKEE, KATIEANN (RN IBCLC)
Entity Type:Individual
Prefix:
First Name:KATIEANN
Middle Name:
Last Name:MCKEE
Suffix:
Gender:F
Credentials:RN IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 16TH ST NE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55906-4217
Mailing Address - Country:US
Mailing Address - Phone:507-990-9892
Mailing Address - Fax:
Practice Address - Street 1:1001 16TH ST NE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55906-4217
Practice Address - Country:US
Practice Address - Phone:507-990-9892
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-15
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN156447-7163W00000X
MNL108397163WL0100X
374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No374J00000XNursing Service Related ProvidersDoula