Shannon L McKenzie
Individual provider Active NPI Home Health Agency · Anchorage, AK
NPI 1417434150 · NPPES record last updated Jul 25, 2018
Key facts
- NPI
- 1417434150
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Home Health Agency 251E00000X
- License
- 1063221 (AK)
- Practice address
- 3913 Lynn Dr
Anchorage, AK 99508-5745 - Phone
- (907) 336-0080
- NPI assigned
- Jul 25, 2018
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| 1063221 | AK | MD | Home Health Agency |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 1063221 | AK | Yes |
Addresses
Primary practice location
3913 Lynn Dr
Anchorage, AK 99508-5745
Mailing address
3913 Lynn Dr
Anchorage, AK 99508-5745
Phone (907) 336-0080
Other providers in Anchorage, AK
- McKenzie Assisted Living
- McKenzie Assisted Living 2
- Laura McKenzie
- Nicole McKenzie
- Rita McKenzie
- Katherine McKibbin
- Katie Jo McKillip
- McKinley Care LLC
- McKinley Care Medical Supplies
- McKinley Services
All providers in Anchorage, AK · Home Health Agency in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 25, 2018. 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.