Provider Demographics
NPI:1700925393
Name:MCKINSEY, ELIZABETH M (LPT)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:M
Last Name:MCKINSEY
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 EDGEDALE DR
Mailing Address - Street 2:SUITE 306
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28804-1701
Mailing Address - Country:US
Mailing Address - Phone:828-775-8088
Mailing Address - Fax:
Practice Address - Street 1:70 WOODFIN PL
Practice Address - Street 2:SUITE 306
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-2463
Practice Address - Country:US
Practice Address - Phone:828-775-8088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5558174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7210192Medicaid
NY079HAOtherBCBS