Individual
MACKENZIE TENOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
10400 75TH ST # 212, KENOSHA, WI 53142-7884
(262) 948-6630
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
14529
WI
363LA2200X
Adult Health Nurse Practitioner
14529
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100262303
—
WI
Enumeration date
11/29/2023
Last updated
02/19/2024
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