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Individual

COLLESE MCKEE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-C

Contact information

Practice address
17321 ST RD 23, SOUTH BEND, IN 46635-1531
(574) 335-8400
(574) 335-0796
Mailing address
707 CEDAR ST STE 405, SOUTH BEND, IN 46617-2059

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71012904A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1102629698
ANTHEM
IN
05
300065654
IN
Enumeration date
06/17/2022
Last updated
02/20/2024
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