Provider Demographics
NPI:1740041854
Name:MEANS, MCKENZIE (CRNP)
Entity type:Individual
Prefix:
First Name:MCKENZIE
Middle Name:
Last Name:MEANS
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 1:2057 ROUTE 130
Mailing Address - Street 2:
Mailing Address - City:JEANNETTE
Mailing Address - State:PA
Mailing Address - Zip Code:15644-3801
Mailing Address - Country:US
Mailing Address - Phone:724-527-2700
Mailing Address - Fax:
Practice Address - Street 1:2057 ROUTE 130
Practice Address - Street 2:
Practice Address - City:JEANNETTE
Practice Address - State:PA
Practice Address - Zip Code:15644-3801
Practice Address - Country:US
Practice Address - Phone:724-527-2700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-17
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP028472363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner