# DR. ANGELIQUE N MCKINNEY-BOURNE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1942306162
- **Gender:** F
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | MD 418042 | PA | Yes |

## Other

- **Enumeration date:** 09/15/2006
- **Last updated:** 06/16/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1148101 | HEALTH AMERICA | PA |
| 01 | — | 1710213236 | CD EAST FAMILY HEALTH & WLLNS. CTR. GROUP NPI | PA |
| 01 | — | 177237 | HIGHMARK MEDICARE | PA |
| 01 | — | 2147159 | HIGHMARK PPO | — |
| 01 | — | 271003587 | TRICARE | PA |
| 01 | — | 50091367 | CAPITAL BLUE CROSS | PA |
| 01 | — | 7615520 | AETNA | PA |