Mckenzie, Jenna M

Mckenzie, Jenna M is an individual health care provider with primary practice located at 640 Hawkins Ave , Lake Ronkonkoma NY 11779-2324. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Mckenzie, Jenna M can be contacted via phone (631) 737-0100.

Contact Information

Primary practice address
640 Hawkins Ave Lake Ronkonkoma NY 11779-2324
Phone: (631) 737-0100
Fax: (631) 471-1117
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 661769 New York
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 340249 New York

Profile Details

NPI number 1225412208
LBN Legal business name Mckenzie, Jenna M
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 19th, 2015
Last updated Sep 21st, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225412208 NPPES
New York MEDICAID 00695941

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