Provider Demographics
NPI:1336938489
Name:WALDREP, MCKENZIE KATE (DO)
Entity type:Individual
Prefix:DR
First Name:MCKENZIE
Middle Name:KATE
Last Name:WALDREP
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:MCKENZIE
Other - Middle Name:KATE
Other - Last Name:ALLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:374 DUNDEE CT
Mailing Address - Street 2:
Mailing Address - City:MARTINEZ
Mailing Address - State:GA
Mailing Address - Zip Code:30907-2558
Mailing Address - Country:US
Mailing Address - Phone:706-834-7063
Mailing Address - Fax:
Practice Address - Street 1:1638 OWEN DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-3424
Practice Address - Country:US
Practice Address - Phone:910-615-3500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program