Individual
JENNIFER C MCKENZIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
F.N.P.
Contact information
Practice address
1206 HIGHWAY 411, VONORE, TN 37885-2455
(423) 442-2622
(423) 442-5760
Mailing address
1206 HIGHWAY 411, VONORE, TN 37885-2455
(423) 442-2622
(423) 442-5760
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
6837
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1507391
—
TN
01
—
3070114
BLUE CROSS BLUE SHIELD #
TN
05
—
3344266
—
TN
05
—
3344267
—
TN
Enumeration date
06/13/2006
Last updated
03/31/2021
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