Active NPI
Maureen M McKenzie, ARNP
- Community Health Nurse Practitioner
- Lynnwood, WA
National Provider Identifier
1154419703
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Nurse Practitioner
- License
- AP30002100
- Practice address
- 4111 194TH St SW
Lynnwood, WA 98036-4604 - Phone
- (425) 775-2589
- Fax
- (425) 775-8846
- NPI assigned
- Oct 10, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Nurse Practitioner | 363LC1500X | AP30002100 | WA | Primary |
Addresses
Primary practice location
4111 194TH St SW
Lynnwood, WA 98036-4604
Mailing address
4111 194TH St SW
Lynnwood, WA 98036-4604
Phone (425) 775-2589
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 187939 | Other | WA | WORKERS COMPENSATION |
| 9614215 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1154419703",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4111 194TH ST SW",
"city": "LYNNWOOD",
"state": "WA",
"postal_code": "980364604",
"telephone_number": "425-775-2589",
"fax_number": "425-775-8846"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4111 194TH ST SW",
"city": "LYNNWOOD",
"state": "WA",
"postal_code": "980364604",
"telephone_number": "425-775-2589",
"fax_number": "425-775-8846"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKENZIE",
"first_name": "MAUREEN",
"middle_name": "M",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-10",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "363LC1500X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Community Health",
"state": "WA",
"license": "AP30002100",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WORKERS COMPENSATION",
"identifier": "187939",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9614215",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lynnwood, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.