Individual
MRS. MACKENZIE PRICE ENNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1906 BELLEVIEW AVE SE, ROANOKE, VA 24014-1838
(540) 981-7000
Mailing address
213 S JEFFERSON ST STE 1006, ROANOKE, VA 24011-1713
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
340766
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
0024188516
VA
Other
Enumeration date
08/30/2023
Last updated
12/22/2023
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