Provider Demographics
NPI:1831933753
Name:MCKENZIE, SHELBY SUEANN (LVN)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:SUEANN
Last Name:MCKENZIE
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1875 POST OAK PARK DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-3310
Mailing Address - Country:US
Mailing Address - Phone:312-468-1433
Mailing Address - Fax:
Practice Address - Street 1:1875 POST OAK PARK DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-3310
Practice Address - Country:US
Practice Address - Phone:312-468-1433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-24
Last Update Date:2024-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX351344164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse