Individual
MS. SUSAN JEAN MACKENZIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1 MEDICAL CENTER DR, LEBANON, NH 03756-1000
(603) 650-1070
(603) 650-1076
Mailing address
1 MEDICAL CENTER DR, LEBANON, NH 03756-1000
(603) 650-1070
(603) 650-1076
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0300
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0AP0959
—
VT
05
—
30330173
—
NH
Enumeration date
06/19/2006
Last updated
11/01/2011
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