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Individual

SHELLEY K MCKENZIE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
950 S TROPICAL TRL, MERRITT ISLAND, FL 32952-5042
(321) 453-8816
Mailing address
950 S TROPICAL TRL, MERRITT ISLAND, FL 32952-5042
(321) 453-8816

Taxonomy

Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3747P1801X
FL
Enumeration date
02/12/2019
Last updated
02/12/2019
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