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General NPI Number Information
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NPI Number | 1730776410
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Entity Type | Individual
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Provider Name | MCKENZIE LYNN BANKS
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Gender | Female
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Dates
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Enumeration Date | 12/28/2020
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Last Update Date | 07/25/2025
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Provider Practice Location Address
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Address Line | 3372 VERDI LN
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City | KENNESAW
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State | GA
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Zip | 30144-2600
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Country | US
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Telephone | 404-969-6163
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Fax | 747-215-5464
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Provider Business Mailing Address
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Address Line | 3372 VERDI LN
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City | KENNESAW
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State | GA
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Zip | 30144-2600
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Country | US
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Telephone | 336-747-0685
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN299977
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License Number State | GA
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