National Provider Identifier
Mackenzey Tallman
Mackenzey Tallman is listed in the NPPES registry with a primary specialty of Pediatric Nurse Practitioner in Geneva, NY and a listed phone number of (315) 787-5200.
Profile Overview
- NPI
- 1396562245
- Provider Type
- Individual
- Primary Specialty
- Pediatric Nurse Practitioner
- Enumeration Date
- September 23, 2024
- Last Updated
- September 23, 2024
Practice Location
- 200 North St Ste 101
- Geneva, NY 14456-1561
Phone: (315) 787-5200
Mailing Address
- 100 Kings Hwy S
- Rochester, NY 14617-5504
Specialties
- Pediatric Nurse Practitioner (363LP0200X)
Full Record
- NPI
- 1396562245
- Entity Type
- Individual
- Last Name
- Tallman
- First Name
- Mackenzey
- Mailing Street Address
- 100 Kings Hwy S
- Mailing City
- Rochester
- Mailing State
- NY
- Mailing ZIP Code
- 14617-5504
- Mailing Country
- US
- Practice Street Address
- 200 North St Ste 101
- Practice City
- Geneva
- Practice State
- NY
- Practice ZIP Code
- 14456-1561
- Practice Country
- US
- Practice Phone
- (315) 787-5200
- Enumeration Date
- September 23, 2024
- Last Updated
- September 23, 2024
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- September 23, 2024
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Pediatric Nurse Practitioner (363LP0200X)