Provider Demographics
NPI:1346554649
Name:MCKENZIE, ROSE MARIE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:ROSE
Middle Name:MARIE
Last Name:MCKENZIE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MRS
Other - First Name:ROSE
Other - Middle Name:MARIE
Other - Last Name:GUENTHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1100 THORNWOOD DRIVE
Mailing Address - Street 2:LOT #615
Mailing Address - City:HEATH
Mailing Address - State:OH
Mailing Address - Zip Code:43056-9547
Mailing Address - Country:US
Mailing Address - Phone:740-258-4643
Mailing Address - Fax:
Practice Address - Street 1:1100 THORNWOOD DRIVE
Practice Address - Street 2:LOT #615
Practice Address - City:HEATH
Practice Address - State:OH
Practice Address - Zip Code:43056-9547
Practice Address - Country:US
Practice Address - Phone:740-258-4643
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-29
Last Update Date:2010-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN100957164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse