Provider Demographics
NPI:1437262367
Name:MCKENZIE, JANET
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name: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:PO BOX 55310
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35255-5310
Mailing Address - Country:US
Mailing Address - Phone:205-731-9701
Mailing Address - Fax:
Practice Address - Street 1:619 19TH STREET SOUTH
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233
Practice Address - Country:US
Practice Address - Phone:205-934-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1032228363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051521913OtherBCBS OF AL
AL891009140Medicaid
AL891009150Medicaid
AL051521949OtherBCBS OF AL
AL891009130Medicaid
AL051524387OtherBCBS OF AL
AL051524388OtherBCBS OF AL
AL051521948OtherBCBS OF AL
AL891007530Medicaid
AL891007550Medicaid
AL051521911OtherBCBS OF AL
AL051521912OtherBCBS OF AL
AL891007580Medicaid
AL891007590Medicaid
AL051521951OtherBCBS OF AL
AL891007540Medicaid
AL051521950OtherBCBS OF AL
AL891007560Medicaid
AL891007570Medicaid
AL891007590Medicaid