MEDICARE: CLAIRE PATRICE MCKENZIE NURSE PRACTITIONER

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	163WC1500X	Community Health Registered Nurse	R205022	MD
2	363LA2200X	Adult Health Nurse Practitioner	R205022	MD

General Provider Information

NPI Number	:	1386392751
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLAIRE PATRICE MCKENZIE NURSE PRACTITIONER

Provider Business Mailing Address
First Line	:	8507 OXON HILL RD STE 200S-3
Second Line	:
City	:	FORT WASHINGTON
State	:	MD
Zip	:	20744-4766
Country	:	US
Telephone Number	:	301-806-0307
Fax Number	:

Provider Business Practice Location Address
First Line	:	8507 OXON HILL RD STE 200S-3
Second Line	:
City	:	FORT WASHINGTON
State	:	MD
Zip	:	20744-4766
Country	:	US
Telephone Number	:	301-806-0307
Fax Number	:

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

Provider Enumeration Date	:	03/15/2022
Last Update Date	:	04/17/2023

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Directions to “ CLAIRE PATRICE MCKENZIE NURSE PRACTITIONER” Practice Location

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