MEDICARE: MRS. ERIN ELIZABETH MCKENZIE FNP-C

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	363LF0000X	Family Nurse Practitioner	APRN.CNP.0033837	OH
2	363LF0000X	Family Nurse Practitioner	LE-00046399	OH

General Provider Information

NPI Number	:	1285324756
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ERIN ELIZABETH MCKENZIE FNP-C

Provider Business Mailing Address
First Line	:	PO BOX 933428
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44193-0039
Country	:	US
Telephone Number	:	234-402-4086
Fax Number	:	234-402-4086

Provider Business Practice Location Address
First Line	:	77 E MIDLOTHIAN BLVD
Second Line	:
City	:	YOUNGSTOWN
State	:	OH
Zip	:	44507-2021
Country	:	US
Telephone Number	:	800-230-7526
Fax Number	:	234-402-4086

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

Provider Enumeration Date	:	05/09/2023
Last Update Date	:	04/16/2024

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