Provider Demographics
NPI:1982423067
Name:MCKINNEY, VINCENT MONROE
Entity type:Individual
Prefix:
First Name:VINCENT
Middle Name:MONROE
Last Name:MCKINNEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 WASHINGTON AVE APT 906
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44113-2627
Mailing Address - Country:US
Mailing Address - Phone:216-424-1983
Mailing Address - Fax:
Practice Address - Street 1:2700 WASHINGTON AVE APT 906
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44113-2627
Practice Address - Country:US
Practice Address - Phone:216-424-1983
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-07
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider