Provider Demographics
NPI:1154696193
Name:MCKAY, KERI ANN (PA-C)
Entity type:Individual
Prefix:MRS
First Name:KERI
Middle Name:ANN
Last Name:MCKAY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12101 HIGHWAY 61
Mailing Address - Street 2:CLINICAL SERVICES DEPARTMENT
Mailing Address - City:STERLING
Mailing Address - State:CO
Mailing Address - Zip Code:80751-8428
Mailing Address - Country:US
Mailing Address - Phone:970-521-8814
Mailing Address - Fax:970-521-8815
Practice Address - Street 1:12101 HIGHWAY 61
Practice Address - Street 2:CLINICAL SERVICES DEPARTMENT
Practice Address - City:STERLING
Practice Address - State:CO
Practice Address - Zip Code:80751-8428
Practice Address - Country:US
Practice Address - Phone:970-521-8814
Practice Address - Fax:970-521-8815
Is Sole Proprietor?:No
Enumeration Date:2012-03-08
Last Update Date:2012-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA-3397363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant