Provider Demographics
NPI:1811712367
Name:MCKENZIE, MARIE LUE (RN)
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:LUE
Last Name:MCKENZIE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20244 MELVILLE ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32833-3859
Mailing Address - Country:US
Mailing Address - Phone:954-328-4301
Mailing Address - Fax:
Practice Address - Street 1:20244 MELVILLE ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32833-3859
Practice Address - Country:US
Practice Address - Phone:954-328-4301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-19
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN3325422163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency