Individual
MACKENZIE NICOLE BAZZILLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN-CNP
Contact information
Practice address
14 COMFORT DR, REEDSVILLE, WV 26547-1401
(304) 864-0006
(304) 864-0015
Mailing address
PO BOX 780, MORGANTOWN, WV 26507-0780
(304) 285-7101
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
123908
WV
Other
Enumeration date
08/13/2025
Last updated
04/30/2026
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