Individual
JANICE MCKENZIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
102 HERITAGE WAY NE STE 302, LEESBURG, VA 20176-4544
(703) 771-5100
(703) 770-0170
Mailing address
102 HERITAGE WAY NE STE 302, LEESBURG, VA 20176-4544
(703) 771-5100
Taxonomy
Speciality
Code
Description
License number
State
163WP2201X
Ambulatory Care Registered Nurse
Primary
0001210014
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101021751400
INNOVATIONS
—
Enumeration date
02/10/2017
Last updated
02/10/2017
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