Individual
JACLYN MCKENZIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1310 M ST, FRESNO, CA 93721-1808
(559) 264-2700
(559) 264-2767
Mailing address
1765 W BROWNING AVE, FRESNO, CA 93711-2310
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
VN289910
CA
Other
Enumeration date
08/10/2016
Last updated
08/10/2016
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