Individual
MCKENZIE MARY MORCOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP, PMHNP-BC
Contact information
Practice address
217 W GEORGIA AVE STE 120, NAMPA, ID 83686-6812
(208) 498-1760
(208) 498-1769
Mailing address
217 W GEORGIA AVE STE 120, NAMPA, ID 83686-6812
(208) 498-1760
(208) 498-1769
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
55738
ID
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
55738
ID
Other
Enumeration date
02/04/2022
Last updated
02/04/2022
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