MEDICARE: JESSE MCKENZIE NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	218146	AR

General Provider Information

NPI Number	:	1275492266
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSE MCKENZIE NP

Provider Business Mailing Address
First Line	:	326 S RIGGSVILLE DR
Second Line	:
City	:	MOUNTAIN VIEW
State	:	AR
Zip	:	72560-6167
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	326 S RIGGSVILLE DR
Second Line	:
City	:	MOUNTAIN VIEW
State	:	AR
Zip	:	72560-6167
Country	:	US
Telephone Number	:	601-517-6552
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/16/2026
Last Update Date	:	05/06/2026

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Directions to “ JESSE MCKENZIE NP” Practice Location

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