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Individual
MCKENZIE DICKSON GREENE
Active
Individual
MCKENZIE DICKSON GREENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-16078
NC
363A00000X
Physician Assistant
085006947
IL
363AM0700X
Medical Physician Assistant
085006947
IL
363AS0400X
Surgical Physician Assistant
085006947
IL
Other
Enumeration date
03/20/2019
Last updated
02/10/2026
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