Provider Demographics
NPI:1407182165
Name:MCKINNEY, ELIZABETH HALL (RN)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:HALL
Last Name:MCKINNEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 REMOUNT RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28203-5013
Mailing Address - Country:US
Mailing Address - Phone:704-332-9001
Mailing Address - Fax:704-332-0124
Practice Address - Street 1:1206 FAIRGROVE CHURCH RD
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-9696
Practice Address - Country:US
Practice Address - Phone:828-464-1172
Practice Address - Fax:828-465-7182
Is Sole Proprietor?:No
Enumeration Date:2009-10-30
Last Update Date:2009-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC051647163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse