Basic Information
| Provider Information | |||||||||
| NPI: | 1396066130 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MCKENZIE | ||||||||
| FirstName: | CHRISTINE | ||||||||
| MiddleName: | PIASCIK | ||||||||
| NamePrefix: | |||||||||
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| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | PIASCIK | ||||||||
| OtherFirstName: | CHRISTINE | ||||||||
| OtherMiddleName: | ADELE | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | UNC FP | ||||||||
| Address2: | PO BOX 271647 | ||||||||
| City: | SALT LAKE CITY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 84127 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9193702583 | ||||||||
| FaxNumber: | 9849744873 | ||||||||
| Practice Location | |||||||||
| Address1: | UNC HOSPITAL DEPARTMENT OF ANESTHESIOLOGY | ||||||||
| Address2: | N2198 UNC HOSPITAL CB# 7010 | ||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275990001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9199665136 | ||||||||
| FaxNumber: | 9849744873 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/16/2010 | ||||||||
| LastUpdateDate: | 10/20/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 10/20/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 165680 | NC | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 1396066130 | 05 | NC | MEDICAID |