Provider Demographics
NPI:1649357484
Name:MCKEE, CAROLINE C, (RD)
Entity type:Individual
Prefix:MRS
First Name:CAROLINE
Middle Name:C,
Last Name:MCKEE
Suffix:
Gender:F
Credentials:RD
Other - Prefix:MRS
Other - First Name:CAROLINE
Other - Middle Name:C
Other - Last Name:MCKEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:811 62ND AVE N
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29572-3210
Mailing Address - Country:US
Mailing Address - Phone:843-449-3629
Mailing Address - Fax:843-828-0338
Practice Address - Street 1:MYRTLE BEACH PRIMARY CARE
Practice Address - Street 2:3381 PHILLIS BLVD
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29577-3210
Practice Address - Country:US
Practice Address - Phone:843-232-2484
Practice Address - Fax:843-828-0338
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2025-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NONE133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered