MRS. MARY JANE MCKINNIE NP NPI 1689774259

NPI Information

  • NPI: 1689774259
  • Provider Name: MRS. MARY JANE MCKINNIE, NP
  • Classification: Nurse Practitioner - 363LA2200X
  • Specialization: Adult Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 905 11TH ST
    LAKE CHARLES, LA
    ZIP 70601
  • Phone: (337) 433-7117

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NPI Details

MRS. Mary Jane Mckinnie, NP is an adult health nurse practitioner in Lake Charles, LA. MRS. Mary Jane Mckinnie, NP NPI is 1689774259. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

905 11TH ST
LAKE CHARLES, LA
ZIP 70601-230
Phone: (337) 433-7117
Fax: (337) 433-7117

The NPI 1689774259 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 9/24/2006 and was last updated on 11/13/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LA2200XNurse PractitionerAdult HealthAP05000LOUISIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11409171MEDICAIDLOUISIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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