Individual
MACKENZIE K SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
200 S HICKORY ST, MAUSTON, WI 53948-1320
(608) 847-9270
Mailing address
200 S HICKORY ST, MAUSTON, WI 53948-1320
(608) 847-9270
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
1087534
WI
Other
Enumeration date
11/13/2025
Last updated
11/13/2025
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