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MRS. LATISHA MCKENZIE NURSE PRACTITIONER

Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1821769878

Individual Registrant:
MRS. LATISHA  MCKENZIE NURSE PRACTITIONER
Gender: F
Not Sole Proprietor

Location and contact information for practice:
2690 MARION SPILLWAY RD  ELMORE, AL 36025-1531 US
Tel: 334-567-2221  Fax: --

Contact information for business:
2690 MARION SPILLWAY RD  ELMORE, AL 36025-1531 US
Tel: 334-567-2221  Fax: --

Registration Information:
NPI: 1821769878
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363LF0000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
Family
AL1-157018

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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