Provider Demographics
NPI:1356554547
Name:MCKENZIE, PATRICIA MARIE (REGISTERED NURSE)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:MARIE
Last Name:MCKENZIE
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:166 ACADEMY ST
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-4828
Mailing Address - Country:US
Mailing Address - Phone:845-485-2094
Mailing Address - Fax:
Practice Address - Street 1:696 DUTCHESS TPKE
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12603-6444
Practice Address - Country:US
Practice Address - Phone:845-471-3584
Practice Address - Fax:845-471-3598
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY391286251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health