Most Relevant Information
Provider Data
| NPI Number: | 1003175860 |
| Provider Name: | SUSAN MARIE MACKENZIE R.N., C.P.N., IBCLC |
| Entity Type: | Individual |
| Taxonomy Code: | 163W00000X |
| Specialty: | Registered Nurse |
| License Number: | 253201 |
Most Important Dates
| Enumeration Date: | 05/14/2012 |
| Last Updated: | 05/14/2012 |
Provider Practice Location
10242 TERRACE RD
SANGER
TX
762665720
Practice Location Phone/Fax
| Phone: | 9405971343 |
| Fax: | 9404587373 |
Provider Mailing Location
10242 TERRACE RD
SANGER
TX
762665720
Provider Mailing Phone/Fax
| Phone: | 9405971343 |
| Fax: | 9404587373 |