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Individual

MISS KELSIE MICHELLE MACKENZIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PNP-AC

Contact information

Practice address
7046 SW ARCHER RD, GAINESVILLE, FL 32608-4723
(352) 733-1770
Mailing address
7046 SW ARCHER RD, GAINESVILLE, FL 32608-4723
(352) 733-1770

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
ARNP9391902
FL
363LP0222X
Critical Care Pediatric Nurse Practitioner
5006157
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
013948500
FL
Enumeration date
04/15/2013
Last updated
01/20/2016
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