Individual
MACKENZIE BLACKBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8500 WASHINGTON ST NE STE A1, ALBUQUERQUE, NM 87113-1861
(505) 828-3837
Mailing address
700 CHILDRENS DR, COLUMBUS, OH 43205-2664
(614) 722-4419
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
58.035028
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/27/2020
Last updated
07/15/2025
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