Provider Demographics
NPI:1902087570
Name:MCKENZIE, LIBBIE PARKER (MD)
Entity Type:Individual
Prefix:DR
First Name:LIBBIE
Middle Name:PARKER
Last Name:MCKENZIE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LIBBIE
Other - Middle Name:LYNN
Other - Last Name:PARKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:410 SIMERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-7804
Mailing Address - Country:US
Mailing Address - Phone:919-812-2684
Mailing Address - Fax:
Practice Address - Street 1:CENTRAL PRISON
Practice Address - Street 2:1300 WESTERN BLVD
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27606
Practice Address - Country:US
Practice Address - Phone:919-733-0800
Practice Address - Fax:919-755-6222
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-23
Last Update Date:2017-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200201053207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology