Provider Demographics
NPI:1336226208
Name:MCKENZIE, BRENDA D (CRNP)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:D
Last Name:MCKENZIE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:BRENDA
Other - Middle Name:
Other - Last Name:MCPARLAND MCKENZIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:1200 OLD YORK RD
Mailing Address - Street 2:2 DULLES
Mailing Address - City:ABINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19001-3720
Mailing Address - Country:US
Mailing Address - Phone:215-481-2000
Mailing Address - Fax:
Practice Address - Street 1:1200 OLD YORK RD
Practice Address - Street 2:
Practice Address - City:ABINGTON
Practice Address - State:PA
Practice Address - Zip Code:19001-3720
Practice Address - Country:US
Practice Address - Phone:215-260-8603
Practice Address - Fax:215-887-1140
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2016-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP007436363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health