Individual
MICHELLE LAVELL MCKENZIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
4109 HIGHWAY 98 W, SUMMIT, MS 39666-9132
(601) 276-3900
Mailing address
4109 HIGHWAY 98 W, SUMMIT, MS 39666-9132
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1-121734
AL
Other
Enumeration date
10/19/2011
Last updated
10/19/2011
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