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Individual

MACKENZIE LYNN AINSWORTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-C

Contact information

Practice address
2130 SW 59TH ST, OKLAHOMA CITY, OK 73119-7025
(405) 303-7555
(405) 561-5615
Mailing address
PO BOX 740020, ATLANTA, GA 30374-0020
(312) 733-9730

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R0118628
OK
363LF0000X
Family Nurse Practitioner
Primary
118628
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200895920
OK
Enumeration date
04/25/2019
Last updated
08/16/2024
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