Basic Information
| Provider Information | |||||||||
| NPI: | 1609220425 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MCKEEL | ||||||||
| FirstName: | ZAKEEDRA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 420 MIMOSA DR | ||||||||
| Address2: | |||||||||
| City: | FERRIDAY | ||||||||
| State: | LA | ||||||||
| PostalCode: | 713343831 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3182677626 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 615 EE WALLACE BLVD S | ||||||||
| Address2: | |||||||||
| City: | FERRIDAY | ||||||||
| State: | LA | ||||||||
| PostalCode: | 713343224 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3187579363 | ||||||||
| FaxNumber: | 3187579364 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/18/2016 | ||||||||
| LastUpdateDate: | 09/18/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 171M00000X | Y | Other Service Providers | Case Manager/Care Coordinator |
No ID Information.