Mckenzie, Jesica Denise

Mckenzie, Jesica Denise is an individual health care provider with primary practice located at 2500 North State Street , Jackson MS 39216-4500. 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, Jesica Denise can be contacted via phone (601) 984-5452.

Contact Information

Primary practice address
2500 North State Street Jackson MS 39216-4500
Phone: (601) 984-5452
Fax: (601) 815-3322
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X R872871 Mississippi
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 8434518-4405 Utah
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 9416834 Florida
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 810649 Mississippi

Profile Details

NPI number 1235480880
LBN Legal business name Mckenzie, Jesica Denise
Credentials NP-C
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 23rd, 2012
Last updated Jan 24th, 2017 - about 7 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 1235480880 NPPES
Mississippi MEDICAID 03638074

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