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General NPI Number Information
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NPI Number | 1891608774
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Entity Type | Individual
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Provider Name | SHELLI-ANN MCKENZIE
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Gender | Female
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Dates
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Enumeration Date | 09/23/2026
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Last Update Date | 09/23/2026
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Provider Practice Location Address
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Address Line | 1971 BIRCH CREST PL
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City | DACULA
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State | GA
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Zip | 30019-3305
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Country | US
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Telephone | 646-420-0190
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Fax |
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Provider Business Mailing Address
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Address Line | 600 W PEACHTREE ST NW STE 1700-106
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City | ATLANTA
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State | GA
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Zip | 30308-3607
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Country | US
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Telephone | 646-420-0190
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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 | 163WA2000X
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Taxonomy Name | Administrator Registered Nurse
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License Number | RN180684
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 163WC1500X
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Taxonomy Name | Community Health Registered Nurse
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License Number | RN180684
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 163WC1600X
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Taxonomy Name | Continuing Education/Staff Development Registered Nurse
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License Number | RN180684
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN180684
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License Number State | GA
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