Provider Demographics
NPI:1144703380
Name:MCKAY, NATALEE T (PA-C)
Entity type:Individual
Prefix:
First Name:NATALEE
Middle Name:T
Last Name:MCKAY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:NATALEE
Other - Middle Name:TAMARA
Other - Last Name:MCKAY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PA-C
Mailing Address - Street 1:8108 PRESTIGE COMMONS DR
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-1302
Mailing Address - Country:US
Mailing Address - Phone:954-263-9978
Mailing Address - Fax:
Practice Address - Street 1:8108 PRESTIGE COMMONS DR
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-1302
Practice Address - Country:US
Practice Address - Phone:954-263-9978
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-13
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023164363A00000X
FL9111511363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant