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General NPI Number Information
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NPI Number | 1205843869
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Entity Type | Individual
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Provider Name | LEZLIE LORRAINE MCKENZIE PMHCNS
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Gender | Female
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Dates
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Enumeration Date | 08/03/2006
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Last Update Date | 04/25/2019
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Provider Practice Location Address
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Address Line | 715A SKYLA CT
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City | MISSOULA
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State | MT
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Zip | 59801
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Country | US
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Telephone | 406-543-2883
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Fax | 406-543-2734
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Provider Business Mailing Address
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Address Line | 715A SKYLA CT
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City | MISSOULA
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State | MT
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Zip | 59801-1480
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Country | US
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Telephone | 406-543-2883
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Fax | 406-543-2734
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364SP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | APRN-LIC-99980
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License Number State | MT
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