Provider Demographics
NPI:1073165825
Name:MCKINNEY, KEVIN W (RN)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:W
Last Name:MCKINNEY
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21655 BIDEN AVE
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19947-4573
Mailing Address - Country:US
Mailing Address - Phone:023-207-9176
Mailing Address - Fax:
Practice Address - Street 1:21655 BIDEN AVE
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:DE
Practice Address - Zip Code:19947-4573
Practice Address - Country:US
Practice Address - Phone:302-207-9176
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-11
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0054480163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse