Individual
MS. MARIAN H MCKENZIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
1808 E AZTEC, #6, GALLUP, NM 87301
(505) 863-9374
(505) 722-7400
Mailing address
1808 E AZTEC, #6, GALLUP, NM 87301
(505) 863-9374
(505) 722-7400
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
R18676
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11858
—
NM
Enumeration date
01/17/2007
Last updated
07/08/2007
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