Individual
MR. JASON D MCKENZIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN, FNP-C
Contact information
Practice address
42 TREADWAY DRIVE, OWINGSVILLE, KY 40360
(606) 674-6396
Mailing address
330 HILLTOP EST, MOREHEAD, KY 40351-9258
(606) 356-5689
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3012593
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1113790
RN
KY
01
—
3012593
APRN
KY
05
—
7100580860
—
KY
01
—
F07180892
AANP NATIONAL CERT.
KY
Enumeration date
11/16/2011
Last updated
10/10/2019
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