Provider Demographics
NPI:1962992479
Name:ANGEL, MCKENZIE DEE (APRN)
Entity type:Individual
Prefix:
First Name:MCKENZIE
Middle Name:DEE
Last Name:ANGEL
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:MCKENZIE
Other - Middle Name:DEE
Other - Last Name:NORRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1158 GREENWOOD RD
Mailing Address - Street 2:
Mailing Address - City:SPRUCE PINE
Mailing Address - State:NC
Mailing Address - Zip Code:28777-8806
Mailing Address - Country:US
Mailing Address - Phone:828-537-2180
Mailing Address - Fax:
Practice Address - Street 1:1158 GREENWOOD RD
Practice Address - Street 2:
Practice Address - City:SPRUCE PINE
Practice Address - State:NC
Practice Address - Zip Code:28777-8806
Practice Address - Country:US
Practice Address - Phone:828-537-2180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-10
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9378202363LP0200X
NC247982363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics