Individual
MR. RENATTO DIEAGO MCKENZIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
718 SMYTH RD, MANCHESTER, NH 03104-7007
(603) 624-4366
Mailing address
27 BLUEBERRY LN, LYNDEBOROUGH, NH 03082-5617
(603) 438-3623
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
069566-21
NH
163WG0000X
General Practice Registered Nurse
RN2297979
MA
Other
Enumeration date
10/04/2023
Last updated
10/04/2023
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