Individual
CORINNE GRACE MACKENZIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4755 OGLETOWN STANTON RD STE 2E99, NEWARK, DE 19718-2200
(302) 733-5982
(302) 733-6081
Mailing address
136 SUNSET VIEW DR, GLEN MILLS, PA 19342-1274
(610) 203-2030
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C5-0011941
DE
Other
Enumeration date
07/10/2023
Last updated
10/23/2023
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