Provider Demographics
NPI:1306323993
Name:MCKENZIE, ANNIE RUTH
Entity type:Individual
Prefix:
First Name:ANNIE
Middle Name:RUTH
Last Name:MCKENZIE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 TRANSMITTER RD LOT 74
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32401-5395
Mailing Address - Country:US
Mailing Address - Phone:850-851-4843
Mailing Address - Fax:
Practice Address - Street 1:700 TRANSMITTER RD LOT 74
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32401-5395
Practice Address - Country:US
Practice Address - Phone:850-851-4843
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-26
Last Update Date:2018-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health