National Provider Identifier
Mackenzie James Stanley, NURSE PRACTITIONER
Mackenzie James Stanley, NURSE PRACTITIONER is listed in the NPPES registry with a primary specialty of Family Nurse Practitioner in Newark, NY and a listed phone number of (315) 332-2022.
Profile Overview
- NPI
- 1790463495
- Provider Type
- Individual
- Primary Specialty
- Family Nurse Practitioner
- Enumeration Date
- July 11, 2023
- Last Updated
- July 11, 2023
Practice Location
- 1200 Driving Park Ave
- Newark, NY 14513-1090
Phone: (315) 332-2022
Specialties
- Family Nurse Practitioner (363LF0000X)
Full Record
- NPI
- 1790463495
- Entity Type
- Individual
- Last Name
- Stanley
- First Name
- Mackenzie
- Middle Name
- James
- Name Prefix
- Mr.
- Credential
- NURSE PRACTITIONER
- Mailing Street Address
- 1200 Driving Park Ave
- Mailing City
- Newark
- Mailing State
- NY
- Mailing ZIP Code
- 14513-1090
- Mailing Country
- US
- Mailing Phone
- (315) 332-2022
- Practice Street Address
- 1200 Driving Park Ave
- Practice City
- Newark
- Practice State
- NY
- Practice ZIP Code
- 14513-1090
- Practice Country
- US
- Practice Phone
- (315) 332-2022
- Enumeration Date
- July 11, 2023
- Last Updated
- July 11, 2023
- Sex
- Male
- Sole Proprietor
- Yes
- Certification Date
- July 11, 2023
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Family Nurse Practitioner (363LF0000X)