Individual
MACKENZIE GUIZIO-CROCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
100 MEDICAL CENTER DR, PRINCETON, KY 42445-2430
(270) 365-0300
Mailing address
100 MEDICAL CENTER DR, PRINCETON, KY 42445-2430
(270) 365-0300
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
3006889
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100159360
—
KY
01
—
P01189418
RAILROAD MEDICARE
KY
Enumeration date
04/06/2011
Last updated
01/08/2020
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