Healthcare Provider Details

I. General information

NPI: 1891604971
Provider Name (Legal Business Name): MCKENZIE K R HALL PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MCKENZIE K RODDY PHD

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1213 10TH AVE N UNIT 2
NASHVILLE TN
37208-3353
US

IV. Provider business mailing address

2525 W END AVE STE 450
NASHVILLE TN
37203-1775
US

V. Phone/Fax

Practice location:
  • Phone: 865-806-7205
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number3769
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: