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Individual
DR. WAYNE MACKENZIE SR.
Active
Individual
DR. WAYNE MACKENZIE SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NURSE PRACTITIONER
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
201250163NP
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
707607
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP4913
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
804045
AHCCCS
AZ
05
—
QXIPQ0000098776
—
AZ
Enumeration date
05/13/2012
Last updated
07/12/2024
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