Individual
LEAH MCKENZI UTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1223 GATEWAY DR, MELBOURNE, FL 32901-2607
(321) 361-5567
(321) 951-3124
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
(321) 361-5567
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
APRN11014188
FL
363LF0000X
Family Nurse Practitioner
11014188
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
112426800
—
FL
01
—
OI662
MEDICARE HF
FL
Enumeration date
10/08/2021
Last updated
06/11/2024
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