Individual
MACKENZIE TRENT RASNAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1490 PARK AVE NW STE 3C, NORTON, VA 24273-1631
(276) 679-0252
Mailing address
1021 W OAKLAND AVE STE 310, JOHNSON CITY, TN 37604-2192
(423) 302-6565
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001272487
VA
363LF0000X
Family Nurse Practitioner
Primary
0024186180
VA
363LF0000X
Family Nurse Practitioner
35927
TN
Other
Enumeration date
12/29/2022
Last updated
06/07/2024
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