Provider Demographics
NPI:1073226023
Name:LAMBIOTTE, MCKENZIE (PA)
Entity type:Individual
Prefix:
First Name:MCKENZIE
Middle Name:
Last Name:LAMBIOTTE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1934 11TH AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-3722
Mailing Address - Country:US
Mailing Address - Phone:304-691-1930
Mailing Address - Fax:304-691-1973
Practice Address - Street 1:1934 11TH AVE - MARSHALL DERMATOLOGY
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-3722
Practice Address - Country:US
Practice Address - Phone:304-691-1930
Practice Address - Fax:304-691-1973
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-04
Last Update Date:2024-12-20
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant