Provider Demographics
NPI:1750779682
Name:MCKENZIE, CLAUDINE (ARNP)
Entity type:Individual
Prefix:
First Name:CLAUDINE
Middle Name:
Last Name:MCKENZIE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3977 NW 36TH TER
Mailing Address - Street 2:
Mailing Address - City:LAUDERDALE LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33309-4803
Mailing Address - Country:US
Mailing Address - Phone:954-673-0013
Mailing Address - Fax:
Practice Address - Street 1:4101 NW 4TH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-2850
Practice Address - Country:US
Practice Address - Phone:954-791-5420
Practice Address - Fax:954-791-5950
Is Sole Proprietor?:No
Enumeration Date:2014-12-30
Last Update Date:2019-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9189292363LP2300X, 363LF0000X
FL9189292363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily