1033429881 NPI number — MS. JAMIE ELIZABETH MACKENZIE RN

Table of content: MS. JAMIE ELIZABETH MACKENZIE RN (NPI 1033429881)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033429881 NPI number — MS. JAMIE ELIZABETH MACKENZIE RN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MACKENZIE
Provider First Name:
JAMIE
Provider Middle Name:
ELIZABETH
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
RN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033429881
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/14/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
USAG-J
Provider Second Line Business Mailing Address:
UNIT 45013 BOX 2578
Provider Business Mailing Address City Name:
APO
Provider Business Mailing Address State Name:
AP
Provider Business Mailing Address Postal Code:
96338-5013
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
312-263-5050
Provider Business Mailing Address Fax Number:
312-263-4100

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
USAG-J MEDDAC PM
Provider Second Line Business Practice Location Address:
UNIT 45013 BOX 2578
Provider Business Practice Location Address City Name:
APO
Provider Business Practice Location Address State Name:
AP
Provider Business Practice Location Address Postal Code:
96338-5013
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
312-263-5050
Provider Business Practice Location Address Fax Number:
312-263-4100
Provider Enumeration Date:
10/14/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163WX0106X , with the licence number:  RN 00074430 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 9261 . This is a "CERTIFIED SPECIALIST AND CASE MANAGER IN OCCUAPTIONL HEALTH" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: RN 00074430 . This is a "REGISTERED NURSE LICENSE" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




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