Individual
LAURA E. MCKINZIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
6812 STATE ROUTE 162, SUITE 21, MARYVILLE, IL 62062-8553
(618) 288-7855
(618) 288-7866
Mailing address
4955 S STATE ROUTE 159, UNIT 1, GLEN CARBON, IL 62034-1907
(618) 288-7855
(618) 288-7866
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209-010209
IL
Other
Enumeration date
02/26/2013
Last updated
06/22/2022
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