Provider Demographics
NPI:1194740571
Name:MCKEE, AMANDA K (MSN, FNP)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:K
Last Name:MCKEE
Suffix:
Gender:F
Credentials:MSN, FNP
Other - Prefix:MISS
Other - First Name:AMANDA
Other - Middle Name:K
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN-FPA, FNP-C, ONP
Mailing Address - Street 1:4121 VETERANS MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:IL
Mailing Address - Zip Code:62864-6262
Mailing Address - Country:US
Mailing Address - Phone:618-242-3778
Mailing Address - Fax:618-242-2551
Practice Address - Street 1:4121 VETERANS MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:IL
Practice Address - Zip Code:62864-6262
Practice Address - Country:US
Practice Address - Phone:618-242-3778
Practice Address - Fax:618-242-2551
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209006092363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL277003830OtherFPA APRN LICENSE
IL377003610OtherFPA APRN CONTROLLED SUBSTANCE
ILK29882Medicare PIN