Individual
PHILLIP SEAN MCKENZIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-BC
Contact information
Practice address
122 12TH ST, PRINCETON, WV 24740-2312
(304) 487-7726
(304) 431-5263
Mailing address
122 12TH ST, PRINCETON, WV 24740-2312
(304) 487-7726
(304) 431-5263
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
1851843114
WV
363LF0000X
Family Nurse Practitioner
Primary
APRN60413-FNP-BC
WV
Other
Enumeration date
11/02/2016
Last updated
03/24/2017
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