Provider Demographics
NPI:1649965153
Name:MCKINLEY, KAREN ELIZABETH (PA-C)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:ELIZABETH
Last Name:MCKINLEY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:915 W REDWOOD RD
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20164-5118
Mailing Address - Country:US
Mailing Address - Phone:303-570-8828
Mailing Address - Fax:
Practice Address - Street 1:43135 BROADLANDS CENTER PLZ
Practice Address - Street 2:
Practice Address - City:BROADLANDS
Practice Address - State:VA
Practice Address - Zip Code:20148-3803
Practice Address - Country:US
Practice Address - Phone:571-206-0742
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-10
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110-008967207RN0300X
VA0110008967363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology