Individual
MACKENZIE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
425 LEWIS HARGETT CIR, LEXINGTON, KY 40503-3590
(859) 268-1030
Mailing address
381 ROCKLICK BRANCH RD, CHAPMANVILLE, WV 25508-7651
(304) 928-4464
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
93493
WV
367500000X
Certified Registered Nurse Anesthetist
Primary
3017780
KY
Other
Enumeration date
04/01/2022
Last updated
05/16/2022
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