Individual
MACKENZIE BLACKWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
1003 WALLACE WAY, GRANDVIEW, WA 98930-8805
(509) 203-1080
Mailing address
11590 RIDGELINE DR STE 130, COLORADO SPRINGS, CO 80921-3969
(970) 508-8101
(970) 585-7849
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1665211
CO
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP70067727
WA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
APN.1000580-NP
CO
Other
Enumeration date
06/05/2024
Last updated
05/12/2026
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