Individual
MACKENZIE NICOLE STUTZMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
10506 MONTGOMERY RD, MONTGOMERY, OH 45242-4487
(513) 865-2227
(513) 865-5552
Mailing address
41 MALL RD, BURLINGTON, MA 01805-0001
(781) 744-8000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN2357906
MA
363LA2100X
Acute Care Nurse Practitioner
APRN.CNP.0026900
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2565399
—
OH
Enumeration date
08/31/2020
Last updated
11/18/2021
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