Provider Demographics
NPI:1508662164
Name:HOWARD, MCKENZIE MIEKO
Entity type:Individual
Prefix:
First Name:MCKENZIE
Middle Name:MIEKO
Last Name:HOWARD
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2559 31ST ST # B105
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80216-4894
Mailing Address - Country:US
Mailing Address - Phone:719-359-0501
Mailing Address - Fax:
Practice Address - Street 1:2559 31ST ST # B105
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80216-4894
Practice Address - Country:US
Practice Address - Phone:719-359-0501
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-24
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program