PHILLIP SEAN MCKENZIE (NPI# 1851843114) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851843114 |
| Entity Type | Individual |
| Full Name | PHILLIP SEAN MCKENZIE |
| Credential | FNP-BC |
| Practice Address |
122 12th St Princeton WV 24740-2312 |
| Practice Telephone | 3044877726 |
| Practice Fax Number | 3044315263 |
| Mailing Telephone | 3044877726 |
| Mailing Fax Number | 3044315263 |
| Enumeration Date | 2016-11-02 |
| Last Update Date | 2017-03-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | 1851843114 | WV | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
APRN60413-FNP-BC | WV | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
122 12TH ST |
| City | PRINCETON |
| State | WV |
| Zip Code | 24740-2312 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326049586 | Thomas Charles Martin Jr. | Pathology | 122 12th St, Princeton, WV 24740-2312 | 2005-08-09 |
| 1508495169 | Valerie Renee Mould | Pharmacist | 122 12th St, Princeton, WV 24740-2312 | 2020-04-06 |
| 1295360501 | Kaitlin Douglas | Nurse Practitioner | 122 12th St, Princeton, WV 24740-2312 | 2020-03-06 |
| 1508310814 | Corey White | Internal Medicine | 122 12th St, Princeton, WV 24740-2312 | 2016-08-04 |
| 1548610975 | Cassidy Smith | Internal Medicine | 122 12th St, Princeton, WV 24740-2312 | 2016-06-16 |
| 1649666488 | Ryan Craddock | Internal Medicine | 122 12th St, Princeton, WV 24740 | 2015-04-08 |
| 1912307323 | Megan Alyse Meadows | Nurse Practitioner | 122 12th St, Princeton, WV 24740-2312 | 2014-09-04 |
| 1497193007 | Shawn L. Vest | Nurse Practitioner | 122 12th St, Princeton, WV 24740-2312 | 2013-06-06 |
| 1780997098 | Arthi Vasudevan Price | Physician Assistant | 122 12th St, Princeton, WV 24740-2312 | 2010-07-16 |
| 1356527311 | Pennie Faith Goins | Nurse Practitioner | 122 12th St, Princeton, WV 24740-2312 | 2008-01-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427658632 | New Beginnings Therapy Services, LLC | Community/Behavioral Health | 616 Harrison Street, Princeton, WV 24740 | 2020-10-27 |
| 1215536222 | Right At Home | Home Health | 313 Locus St, Princeton, WV 24740 | 2020-10-21 |
| 1881208098 | Robin Lane | Technician | 174 Tea Kettle Road, Princeton, WV 24740 | 2020-09-04 |
| 1134739824 | Nona Arthur | Technician | 708 Bluefiled Ave, Princeton, WV 24740 | 2020-08-06 |
| 1851909014 | Tina B Altizer | Speech-Language Pathologist | 120 12th Street, Princeton, WV 24740 | 2020-07-14 |
| 1245712504 | Tracy Jean Mitchell | Speech-Language Pathologist | 1200 Mercer St, Princeton, WV 24740 | 2018-09-04 |
| 1700305240 | Tina Six | Registered Nurse | 1403 Honaker Avenue, Princeton, WV 24740 | 2017-09-15 |
| 1013449172 | Karin Cappa | Pharmacist | 669 Cornfield Rd, Princeton, WV 24740 | 2017-03-29 |
| 1942661723 | Virginia Chryssikos | Social Worker | 3016 E Cumberland Road, Bluestone Family Practice, Bluefield, WV 24740 | 2016-03-08 |
| 1477939460 | Kathy Diane Wyrick | Counselor | 220 South Walker Street, Princeton, WV 24740 | 2015-08-03 |
| Find all providers in zip 24740 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306452800 | Beverly Christine Young | Nurse Practitioner | 608 New Hope Rd Ste 8, Princeton, WV 24740-2287 | 2020-09-20 |
| 1699313916 | Alla Hodges | Nurse Practitioner | 1507 Jonathan Ct, Princeton, NJ 08540-9565 | 2019-12-17 |
| 1760027692 | Florence J Choge | Nurse Practitioner | 3626 Route 1, Princeton Wound Care Center, Princeton, NJ 08450-5922 | 2019-11-14 |
| 1538701313 | Kanan H. Bhatt | Nurse Practitioner | 29 Rutgers Ln, Princeton, NJ 08540-7934 | 2019-10-12 |
| 1255994950 | Alicia Arkell | Nurse Practitioner | 515 Mercer St, Princeton, WV 24740-3109 | 2019-04-17 |
| 1639681265 | Melissa S Mclain | Nurse Practitioner | 530 Park Ave E Ste 207, Princeton, IL 61356-3902 | 2017-11-05 |
| 1124538830 | Shandalyn Ann Cerda | Nurse Practitioner | 321 Timbercreek Ct, Princeton, TX 75407-5738 | 2017-10-08 |
| 1790092195 | Sarah Megan Spencer | Nurse Practitioner | 402 East Dr, Princeton, WV 24740 | 2010-09-07 |
| 1043443229 | Lynn Marie Calvert | Nurse Practitioner | 311 E Princeton Dr, Princeton, TX 75407-9008 | 2009-09-03 |
| 1275757619 | Sara T Ingraffia | Nurse Practitioner | Princeton University Health Serv Mccosh Health Ctr, Washington Road, Princeton, NJ 08544-0001 | 2007-04-13 |
| Find all providers in PRINCETON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.