Provider Demographics
NPI:1801519483
Name:MCKEE, TAMMY
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:
Last Name:MCKEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 E CLAY ST STE 103
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:VA
Mailing Address - Zip Code:24153-3779
Mailing Address - Country:US
Mailing Address - Phone:540-314-4607
Mailing Address - Fax:540-380-3127
Practice Address - Street 1:30 E CLAY ST STE 103
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153-3779
Practice Address - Country:US
Practice Address - Phone:540-314-4607
Practice Address - Fax:540-380-3127
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-20
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO-2314673747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant