Provider Demographics
NPI:1376944827
Name:MCKENZIE-MATTHEWS, JANE E
Entity Type:Individual
Prefix:MS
First Name:JANE
Middle Name:E
Last Name:MCKENZIE-MATTHEWS
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 1:31 BIRCHWOOD LN
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28805-2601
Mailing Address - Country:US
Mailing Address - Phone:828-337-1045
Mailing Address - Fax:
Practice Address - Street 1:31 BIRCHWOOD LN
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28805-2601
Practice Address - Country:US
Practice Address - Phone:828-337-1045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-15
Last Update Date:2014-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor