Provider Demographics
NPI:1083464614
Name:MCKENZIE, CAIYLE ANN (APNP)
Entity Type:Individual
Prefix:
First Name:CAIYLE
Middle Name:ANN
Last Name:MCKENZIE
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6967 N 84TH ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53224-4829
Mailing Address - Country:US
Mailing Address - Phone:414-791-8112
Mailing Address - Fax:
Practice Address - Street 1:2323 N MAYFAIR RD STE 440
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-1534
Practice Address - Country:US
Practice Address - Phone:414-915-5554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-26
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15024-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily