Provider Demographics
NPI:1215282215
Name:MCKEE, DEANNA ROARK (NP)
Entity type:Individual
Prefix:
First Name:DEANNA
Middle Name:ROARK
Last Name:MCKEE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 THOMAS RD.
Mailing Address - Street 2:STE 107
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71291
Mailing Address - Country:US
Mailing Address - Phone:318-322-7726
Mailing Address - Fax:318-322-2614
Practice Address - Street 1:2503 BROADMOOR BLVD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-2987
Practice Address - Country:US
Practice Address - Phone:318-322-7726
Practice Address - Fax:318-322-2614
Is Sole Proprietor?:No
Enumeration Date:2012-07-17
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LATAP002935363LA2100X
LAAP07044363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care