Individual ProviderMichelle MckenzieNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address85 W Burnside Ave, Bronx, NY 10453-4015(815) 383-2090PECOS EnrollmentBased on the most recent information from CMS, provider Michelle Mckenzie does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 4 days ago.Profile DetailsProvider ID1588239438Provider TypeIndividualFull NameMckenzie, MichelleCredentialFNPGenderFemaleSole ProprietorNoEnumeration Date5/24/2021Last Updated5/24/2021Contact InformationPractice LocationPractice Address85 W Burnside Ave, Bronx, NY 10453-4015Phone(815) 383-2090FaxUnlisted FaxMailing LocationMailing Address85 W Burnside Ave, Bronx, NY 10453-4015Phone(815) 383-2090FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense209.022648Illinois