Provider Demographics
NPI:1902594559
Name:MCALISTER, MCKINZE (APRN)
Entity Type:Individual
Prefix:
First Name:MCKINZE
Middle Name:
Last Name:MCALISTER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 E HICKORY AVE
Mailing Address - Street 2:
Mailing Address - City:CRESTVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:32536-2742
Mailing Address - Country:US
Mailing Address - Phone:850-683-1100
Mailing Address - Fax:850-683-0599
Practice Address - Street 1:502 E HICKORY AVE
Practice Address - Street 2:
Practice Address - City:CRESTVIEW
Practice Address - State:FL
Practice Address - Zip Code:32536-2742
Practice Address - Country:US
Practice Address - Phone:850-683-1100
Practice Address - Fax:850-683-0599
Is Sole Proprietor?:No
Enumeration Date:2023-05-01
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9490966163W00000X
FL11026738363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse