Individual
MRS. NANCY J MCKENZIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
110 E 16TH ST, EUREKA, KS 67045-1067
(620) 583-7451
(620) 583-6702
Mailing address
110 E 16TH ST, EUREKA, KS 67045-1067
(620) 583-7451
(620) 583-6702
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
KS148
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100352110C
—
KS
01
—
100428860A
GROUP MEDICAID
—
01
—
178960
RURAL HEALTH MEDICARE
—
Enumeration date
09/14/2005
Last updated
06/26/2012
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