MEDICARE: MS. JULIA KERNS MCKENZIE APN

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	26NR14581400	NJ
2	363LF0000X	Family Nurse Practitioner	SP017128	PA

General Provider Information

NPI Number	:	1447530159
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JULIA KERNS MCKENZIE APN

Provider Business Mailing Address
First Line	:	1601 CHESTNUT STREET
Second Line	:	TL04B
City	:	PHILADELPHIA
State	:	PA
Zip	:	19192
Country	:	US
Telephone Number	:	215-761-6080
Fax Number	:	215-761-5602

Provider Business Practice Location Address
First Line	:	1601 CHESTNUT STREET
Second Line	:	TL04B
City	:	PHILADELPHIA
State	:	PA
Zip	:	19192
Country	:	US
Telephone Number	:	215-761-6080
Fax Number	:

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

Provider Enumeration Date	:	08/25/2011
Last Update Date	:	09/10/2022

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