Individual
MARY JANE MCKEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C
Contact information
Practice address
8911 LIBERTY MILLS RD, FORT WAYNE, IN 46804-6311
(260) 373-9465
(260) 266-9406
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10000469A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
970023100
RR MEDICARE
IN
Enumeration date
08/11/2005
Last updated
03/27/2023
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