Individual
MCKENZIE WALTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FP-C
Contact information
Practice address
800 GLENWILD CIR., CANTON, MS 39046
(601) 405-5202
Mailing address
800 GLENWILD CIR., CANTON, MS 39046
(601) 405-5202
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
24795
SC
363LF0000X
Family Nurse Practitioner
Primary
905818
MS
Other
Enumeration date
02/09/2022
Last updated
04/26/2023
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