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Individual

ADDIE MCKENZIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CPNP

Contact information

Practice address
33 MOLLISON WAY, LEWISTON, ME 04240
(207) 784-5782
Mailing address
11 SPRING HILL RD, MERRIMAC, MA 01860-2260

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2306355
MA
163W00000X
Registered Nurse
RN72450
ME
363LP0200X
Pediatric Nurse Practitioner
2306355
MA
363LP0200X
Pediatric Nurse Practitioner
Primary
CNP181095
ME

Other

Enumeration date
02/01/2017
Last updated
06/12/2018
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