Individual
VANESSA MCKENZIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1200 E RAINES RD STE 101, MEMPHIS, TN 38116-5829
(866) 364-8944
(877) 319-1936
Mailing address
1200 E RAINES RD STE 101, MEMPHIS, TN 38116-5829
(866) 364-8944
(877) 319-1936
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
17796
MS
207R00000X
Internal Medicine Physician
Primary
25678
TN
207R00000X
Internal Medicine Physician
A45867
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00126757
—
MS
01
—
110108905
RAILROAD MEDICARE
TN
01
—
3031027
BLUE CROSS BLUE SHIELD TN
TN
05
—
3093293
—
TN
01
—
5001948
TLC
TN
Enumeration date
07/05/2006
Last updated
05/15/2024
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