Lake, Mckenzie Mack
Lake, Mckenzie Mack is an individual health care provider with primary practice located at 3001 Broadmoor Blvd Ne , Rio Rancho NM 87144-2100. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Lake, Mckenzie Mack can be contacted via phone (505) 550-9863.Contact Information
Primary practice address
3001 Broadmoor Blvd Ne
Rio Rancho NM 87144-2100
Phone: (505) 550-9863
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | CNP-02964 | New Mexico |
Profile Details
| NPI number | 1346793445 |
|---|---|
| LBN Legal business name | Lake, Mckenzie Mack |
| Credentials | Family Nurse Practitioner (FNP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 26th, 2016 |
| Last updated | Oct 2nd, 2023 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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