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Individual

KATHLEEN MACKENZIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
1007 N MAIN ST, DAYVILLE, CT 06241-2170
(860) 774-2020
Mailing address
177 GARY SCHOOL RD, PUTNAM, CT 06260-1861

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
7398
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
7398
APRN LICENSE NUMBER
CT
Enumeration date
12/13/2017
Last updated
12/06/2019
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