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NPI Code Detail

MEDICARE: TRACY MCKENZIE APRN

MEDICARE: TRACY MCKENZIE APRN
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
1363LF0000XFamily Nurse PractitionerAPRN11032810FL

General Provider Information

NPI Number : 1427897982
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRACY MCKENZIE APRN
Provider Business Mailing Address
First Line : 2675 WINKLER AVE FL 2
Second Line :
City : FORT MYERS
State : FL
Zip : 33901-9342
Country : US
Telephone Number : 877-856-3774
Fax Number :
Provider Business Practice Location Address
First Line : 705 FERRIS ST
Second Line :
City : GREEN COVE SPRINGS
State : FL
Zip : 32043-4025
Country : US
Telephone Number : 904-284-4510
Fax Number : 904-284-3293
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2024
Last Update Date : 08/06/2025

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Directions to “ TRACY MCKENZIE APRN” Practice Location

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