Mckenzie, Kelly Sue

Mckenzie, Kelly Sue is an individual health care provider with primary practice located at 12500 Willowbrook Rd Western Md Regional Health System, Cumberland MD 21502-6393. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Mckenzie, Kelly Sue can be contacted via phone (240) 964-3306.

Contact Information

Primary practice address
12500 Willowbrook Rd Western Md Regional Health System Cumberland MD 21502-6393
Phone: (240) 964-3306
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 51177 West Virginia
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 049080 Maryland

Profile Details

NPI number 1750312633
LBN Legal business name Mckenzie, Kelly Sue
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 6th, 2006
Last updated Feb 19th, 2019 - about 6 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 1750312633 NPPES
Maryland MEDICAID 854129900

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