Individual
MACKENZIE ROCHON CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
5395 E CHERYL PKWY, FITCHBURG, WI 53711-5395
(608) 276-4660
Mailing address
5395 E CHERYL PKWY, FITCHBURG, WI 53711-5395
(608) 276-4660
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
155942-30
WI
363LA2200X
Adult Health Nurse Practitioner
Primary
4852-33
WI
Other
Enumeration date
06/21/2013
Last updated
05/11/2023
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