Provider Demographics
NPI:1558234195
Name:LATZEL, MEKENZIE MARIE
Entity type:Individual
Prefix:
First Name:MEKENZIE
Middle Name:MARIE
Last Name:LATZEL
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 1:4410 S 37TH ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-1011
Mailing Address - Country:US
Mailing Address - Phone:402-904-1168
Mailing Address - Fax:
Practice Address - Street 1:4410 S 37TH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-1011
Practice Address - Country:US
Practice Address - Phone:402-904-1168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-29
Last Update Date:2025-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374700000XNursing Service Related ProvidersTechnician