Most Relevant Information
Provider Data
| NPI Number: | 1003215526 |
| Provider Name: | WILMA ANNE MACKENZIE AGACNP-BC |
| Entity Type: | Individual |
| Taxonomy Code: | 363LA2100X |
| Specialty: | Nurse Practitioner |
| License Number: | 4704280979 |
Most Important Dates
| Enumeration Date: | 08/20/2014 |
| Last Updated: | 11/25/2019 |
Provider Practice Location
1500 E MEDICAL CENTER DR
ANN ARBOR
MI
481095000
Practice Location Phone/Fax
| Phone: | 7349364000 |
| Fax: |
Provider Mailing Location
3621 S STATE ST
ANN ARBOR
MI
481081633
Provider Mailing Phone/Fax
| Phone: | 7346475299 |
| Fax: |