Individual
MRS. LATISHA MCKENZIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
23 OLD SCHOOL RD, GEORGETOWN, GA 39854-4627
(229) 334-9353
Mailing address
23 OLD SCHOOL RD, GEORGETOWN, GA 39854-4627
(229) 334-9353
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
GAA-NP001043
GA
Other
Enumeration date
09/21/2021
Last updated
09/20/2022
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