Provider Demographics
NPI:1275312969
Name:MCKENZIE, VERONICA (RN)
Entity Type:Individual
Prefix:MRS
First Name:VERONICA
Middle Name:
Last Name:MCKENZIE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 FRONT LAKE DR
Mailing Address - Street 2:
Mailing Address - City:PIKE ROAD
Mailing Address - State:AL
Mailing Address - Zip Code:36064-3707
Mailing Address - Country:US
Mailing Address - Phone:334-318-2968
Mailing Address - Fax:
Practice Address - Street 1:1902 BULLARD ST
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-1716
Practice Address - Country:US
Practice Address - Phone:334-318-2968
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-22
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-060405163WG0600X, 163WX1500X, 163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WG0600XNursing Service ProvidersRegistered NurseGerontology
No163WX1500XNursing Service ProvidersRegistered NurseOstomy Care