Provider Demographics
NPI:1932777919
Name:MCKENZIE, SARA (LPN)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:MCKENZIE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:
Other - Last Name:SAYLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:36 FREDRIC WAY
Mailing Address - Street 2:
Mailing Address - City:HINESBURG
Mailing Address - State:VT
Mailing Address - Zip Code:05461-4430
Mailing Address - Country:US
Mailing Address - Phone:802-922-0882
Mailing Address - Fax:
Practice Address - Street 1:125 PLACE RD E
Practice Address - Street 2:
Practice Address - City:HINESBURG
Practice Address - State:VT
Practice Address - Zip Code:05461-8906
Practice Address - Country:US
Practice Address - Phone:802-735-7376
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-15
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT025.0134890164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse