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McKenzie Lueken

Physician Assistant in Evansville, IN. Individual provider (NPI-1).

NPI number1003418682
StatusActive
Last updated in NPPESMar 11, 2021

Details

NPI
1003418682
Entity type
Individual (NPI-1)
Name
McKenzie Lueken
Sex
Female
Sole proprietor
Yes
Enumeration date
Nov 10, 2020
Certification date
Mar 11, 2021
Last updated
Mar 11, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363A00000X Physician Assistant10003101AINYes
363AM0700X Physician Assistant, Medical––

Practice location

120 Se 4th St
Evansville, IN 47708-1607

Phone 812-426-9311 · Fax 812-426-9839

Mailing address

Po Box 1510
Evansville, IN 47706-1510

Phone 812-450-6815 · Fax 812-450-6822

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