Provider Demographics
NPI:1629096516
Name:MCKENZIE, LINDA KAY (CRNA)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:KAY
Last Name:MCKENZIE
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:KAY
Other - Last Name:BILLOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:11143 W 17TH AVE
Mailing Address - Street 2:APT 106
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80215-6204
Mailing Address - Country:US
Mailing Address - Phone:858-344-6221
Mailing Address - Fax:
Practice Address - Street 1:300 E HAMPDEN AVE #202
Practice Address - Street 2:OB GYN ANESTHESIA PC
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-2654
Practice Address - Country:US
Practice Address - Phone:303-789-1940
Practice Address - Fax:303-789-2132
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10874367500000X
CO106200367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1629096516Medicaid