Provider Demographics
NPI:1982765954
Name:MCKEE, BRENDA SUE (STNA)
Entity Type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:SUE
Last Name:MCKEE
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 RIFFLE RD
Mailing Address - Street 2:
Mailing Address - City:WEST UNION
Mailing Address - State:OH
Mailing Address - Zip Code:45693
Mailing Address - Country:US
Mailing Address - Phone:937-544-7192
Mailing Address - Fax:937-544-7192
Practice Address - Street 1:137 RIFFLE RD
Practice Address - Street 2:
Practice Address - City:WEST UNION
Practice Address - State:OH
Practice Address - Zip Code:45693
Practice Address - Country:US
Practice Address - Phone:937-544-7192
Practice Address - Fax:937-544-7192
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH400096180302374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2519644OtherPROVIDER NUMBER