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NPI Code Detail

MEDICARE: MCKENZIE IVERSON

MEDICARE:   MCKENZIE  IVERSON
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
1101Y00000XCounselor

General Provider Information

NPI Number : 1346075918
Entity Type Code : Individual
Provider Name (Legal Business Name) : MCKENZIE IVERSON
Provider Business Mailing Address
First Line : 7700 HASKINS ST
Second Line :
City : SHAWNEE
State : KS
Zip : 66216-3034
Country : US
Telephone Number : 913-269-2123
Fax Number :
Provider Business Practice Location Address
First Line : 901 W MAIN ST STE 200
Second Line :
City : BLUE SPRINGS
State : MO
Zip : 64015-3743
Country : US
Telephone Number : 816-375-4579
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/04/2024
Last Update Date : 09/04/2024

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Directions to “ MCKENZIE IVERSON ” Practice Location

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