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General NPI Number Information
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NPI Number | 1235970948
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Entity Type | Organization
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Legal Business Name | JESIKAMCKENZIEBHI LLC
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Dates
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Enumeration Date | 06/05/2024
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Last Update Date | 10/06/2025
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Provider Practice Location Address
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Address Line | 10142 W GROSS AVE
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City | TOLLESON
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State | AZ
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Zip | 85353-1204
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Country | US
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Telephone | 602-550-8795
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Fax | 602-997-7126
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Provider Business Mailing Address
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Address Line | 1805 N SCOTTSDALE RD STE 1
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City | TEMPE
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State | AZ
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Zip | 85288-1556
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Country | US
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Telephone | 855-432-5551
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Fax | 855-432-5559
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Authorized Official
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Title or Position | OWNER
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Name | JESIKA LOUANA MCKENZIE
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Credential | PMHNP
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Telephone | 602-550-8795
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364SP0808X
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Taxonomy Name | Psychiatric/Mental Health Clinical Nurse Specialist
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License Number |
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License Number State |
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