Provider Demographics
NPI:1447530159
Name:MCKENZIE, JULIA KERNS (APN)
Entity type:Individual
Prefix:MS
First Name:JULIA
Middle Name:KERNS
Last Name:MCKENZIE
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 CHESTNUT STREET
Mailing Address - Street 2:TL04B
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19192
Mailing Address - Country:US
Mailing Address - Phone:215-761-6080
Mailing Address - Fax:215-761-5602
Practice Address - Street 1:1601 CHESTNUT STREET
Practice Address - Street 2:TL04B
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19192
Practice Address - Country:US
Practice Address - Phone:215-761-6080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-25
Last Update Date:2022-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR14581400363LF0000X
PASP017128363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily