Provider Demographics
NPI:1386799708
Name:MCGEE, KATHLEEN ANNE (MA)
Entity type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:ANNE
Last Name:MCGEE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 S 500 W
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:IN
Mailing Address - Zip Code:46052-9464
Mailing Address - Country:US
Mailing Address - Phone:317-840-4675
Mailing Address - Fax:765-482-4851
Practice Address - Street 1:905 S 500 W
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:IN
Practice Address - Zip Code:46052-9464
Practice Address - Country:US
Practice Address - Phone:317-840-4675
Practice Address - Fax:765-482-4851
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN929325174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty