Angela Maxine McKenzie, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

LPN070160 Issued in GA

Practice address

645 Wildboar CT
Fairburn, GA 30213-2192

Phone

(770) 306-2011

Fax

(770) 306-2011

NPI assigned

Jul 19, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1184803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184803200000",
    "number": "1447450325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 WILDBOAR CT",
            "city": "FAIRBURN",
            "state": "GA",
            "postal_code": "302132192",
            "telephone_number": "770-306-2011",
            "fax_number": "770-306-2011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 WILDBOAR CT",
            "city": "FAIRBURN",
            "state": "GA",
            "postal_code": "302132192",
            "telephone_number": "770-306-2011",
            "fax_number": "770-306-2011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENZIE",
        "first_name": "ANGELA",
        "middle_name": "MAXINE",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-19",
        "last_updated": "2007-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "GA",
            "license": "LPN070160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Larina Deireland Matthews
• Lynne Mayi
• MC Grath Community Chiropractic
• Nelsonya C McAdoo, M. ED.
• John Wayne McGrath, D.C.
• Judith Nicole McLeod
• Youlanda Latasha McRae
• Me Times Two LLC
• John Meddling, LCMT
• Karen Melton, OTR/L

• Licensed Practical Nurse in Fairburn, GA
• Providers in Fairburn, GA by specialty
• Licensed Practical Nurse in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.