Mckenzie, Kenneth Chandler

Mckenzie, Kenneth Chandler is an individual health care provider with primary practice located at 1401 W 5Th St , Sheridan WY 82801-2705. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Mckenzie, Kenneth Chandler can be contacted via phone (307) 672-1161.

Contact Information

Primary practice address
1401 W 5Th St Sheridan WY 82801-2705
Phone: (307) 672-1161
Fax: (307) 672-2791
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA - 1194 Idaho
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA176761 Oregon
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA728 Wyoming

Profile Details

NPI number 1356744890
LBN Legal business name Mckenzie, Kenneth Chandler
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 29th, 2014
Last updated Oct 24th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356744890 NPPES
Wyoming MEDICAID 147317400

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