| NPI | 1467173104 |
|---|---|
| Former Name | LACYANN MCKENZIE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11022088) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9477599) |
| Enumeration Date | 2022-09-12 |
| Last Update Date | 2023-02-21 |