=====================================================
General NPI Number Information
=====================================================
NPI Number | 1417348657
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | AMBER D MCKENZIE RN, FNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/10/2015
-----------------------------------------------------
Last Update Date | 09/26/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 20320 NORTHWEST FWY STE 400A
-----------------------------------------------------
City | JERSEY VILLAGE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77065-5620
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 725-209-3053
-----------------------------------------------------
Fax | 855-927-7788
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10680 MEDLOCK BRIDGE RD STE 101
-----------------------------------------------------
City | JOHNS CREEK
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30097-8420
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 725-209-3053
-----------------------------------------------------
Fax | 855-927-7788
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | 230626
-----------------------------------------------------
License Number State | AR
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | APRN-4931
-----------------------------------------------------
License Number State | HI
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | 5021077
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | 2024046586
-----------------------------------------------------
License Number State | MO
-----------------------------------------------------
Taxonomy #5
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | 10035087
-----------------------------------------------------
License Number State | OR
-----------------------------------------------------
Taxonomy #6
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | C-APN.0103188-C-NP
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------
Taxonomy #7
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | 4031218
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------
Taxonomy #8
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | APRN11036321
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #9
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | AP127441
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------
Taxonomy #10
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | GAA-NP003108
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------
Taxonomy #11
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | 319180
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------
Taxonomy #12
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | 29551
-----------------------------------------------------
License Number State | SC
-----------------------------------------------------
Taxonomy #13
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | 3-002209
-----------------------------------------------------
License Number State | AL
-----------------------------------------------------
Taxonomy #14
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | 37556
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------
Taxonomy #15
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | 0037697
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------