Provider Demographics
NPI:1366823486
Name:FLOWERS MCKENZIE, SHARON
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:FLOWERS MCKENZIE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5966 RIDGE LAKE CIR
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32967-5092
Mailing Address - Country:US
Mailing Address - Phone:772-360-5553
Mailing Address - Fax:
Practice Address - Street 1:5966 RIDGE LAKE CIR
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32967-5092
Practice Address - Country:US
Practice Address - Phone:772-360-5553
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-15
Last Update Date:2015-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL108444376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide