Elizabeth Jean McKenzie, APRN
Individual provider Active NPI Pediatric Nurse Practitioner · Deville, LA
NPI 1164032462 · NPPES record last updated Aug 3, 2020
Key facts
- NPI
- 1164032462
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Nurse Practitioner 363LP0200X
- License
- 212175 (LA)
- Practice address
- 121 Shady Crest Ave
Deville, LA 71328-4000 - Phone
- (318) 794-5552
- NPI assigned
- Aug 3, 2020
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN144652 | LA | MD | Pediatric Registered Nurse |
| 212175 | LA | MD | Pediatric Nurse Practitioner |
Interoperability endpoints
- elizabeth.mckenzie.2@22920.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Registered Nurse | 163WP0200X | RN144652 | LA | |
| Pediatric Nurse Practitioner | 363LP0200X | 212175 | LA | Yes |
Addresses
Primary practice location
121 Shady Crest Ave
Deville, LA 71328-4000
Mailing address
121 Shady Crest Ave
Deville, LA 71328-4000
Phone (318) 794-5552
Other providers in Deville, LA
- Sue May Liu
- Amanda Louise Lluvera
- Everett Clifton Lofton
- Edmon Liston Mapp Jr.
- Mary McCormick
- Stacey McPherson
- Lacie Nugent
- Erin Franks Owens
- Allison Smith Pospisil
- Jared Wiggins
All providers in Deville, LA · Pediatric Nurse Practitioner in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 3, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.