Provider Demographics
NPI:1851735583
Name:MCKENZIE, ANNA MARIE (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:MARIE
Last Name:MCKENZIE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 FIELDSTOWN RD
Mailing Address - Street 2:SUITE 124
Mailing Address - City:GARDENDALE
Mailing Address - State:AL
Mailing Address - Zip Code:35071-2408
Mailing Address - Country:US
Mailing Address - Phone:205-285-8252
Mailing Address - Fax:
Practice Address - Street 1:210 FIELDSTOWN RD
Practice Address - Street 2:SUITE 124
Practice Address - City:GARDENDALE
Practice Address - State:AL
Practice Address - Zip Code:35071-2408
Practice Address - Country:US
Practice Address - Phone:205-285-8252
Practice Address - Fax:205-285-8262
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-24
Last Update Date:2013-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-111601363LF0000X
GARN228788363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily