Mckenzie, Mary

Mckenzie, Mary is an individual health care provider with primary practice located at 2021 W Loop 281 , Longview TX 75604-2504. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Mckenzie, Mary can be contacted via phone (903) 295-1396.

Contact Information

Primary practice address
2021 W Loop 281 Longview TX 75604-2504
Phone: (903) 295-1396
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 556727 Texas

Profile Details

NPI number 1013012509
LBN Legal business name Mckenzie, Mary
Credentials FNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 13th, 2006
Last updated Sep 10th, 2012 - about 13 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 1013012509 NPPES
Texas Other 8N3057 BLUE CROSS BLUE SHIELD
Texas MEDICAID 127102509 BLUE CROSS BLUE SHIELD

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