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Individual

MACKENZIE ROSE LEEKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LM, CPM

Contact information

Practice address
508 REDBUD WAY, NEVADA CITY, CA 95959-2156
(530) 277-2043
(530) 572-1524
Mailing address
508 REDBUD WAY, NEVADA CITY, CA 95959-2156
(530) 277-2043
(530) 572-1524

Taxonomy

Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
LM500
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1114456340
NPPES
CA
Enumeration date
06/10/2017
Last updated
07/16/2024
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