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Individual

MRS. SUSAN MARIE MACKENZIE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
R.N., C.P.N., IBCLC

Contact information

Practice address
10242 TERRACE RD, SANGER, TX 76266-5720
(940) 597-1343
(940) 458-7373
Mailing address
10242 TERRACE RD, SANGER, TX 76266-5720
(940) 597-1343
(940) 458-7373

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
253201
TX
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
11063217
TX

Other

Enumeration date
05/14/2012
Last updated
05/14/2012
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