Provider Demographics
NPI:1568632925
Name:MCKENZIE, CASSANDRA ELIZABETH (REGISTERED NURSE MSN)
Entity Type:Individual
Prefix:MRS
First Name:CASSANDRA
Middle Name:ELIZABETH
Last Name:MCKENZIE
Suffix:
Gender:F
Credentials:REGISTERED NURSE MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:919 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33972-2921
Mailing Address - Country:US
Mailing Address - Phone:305-625-7430
Mailing Address - Fax:305-625-1079
Practice Address - Street 1:919 5TH AVE
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33972-2921
Practice Address - Country:US
Practice Address - Phone:305-625-7430
Practice Address - Fax:305-625-1079
Is Sole Proprietor?:No
Enumeration Date:2008-03-01
Last Update Date:2008-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1703942163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse