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Individual
MCKENZIE ANN NELSON
Active
Individual
MCKENZIE ANN NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.200718
LA
363AS0400X
Surgical Physician Assistant
PA.200718
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2370138
—
LA
Enumeration date
07/09/2014
Last updated
03/15/2019
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