Mackenzie Renee Laisure, PHARMD

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

P10304 Issued in ID

Practice address

215 N Main St
White River Junction, VT 05009-0001

Phone

(802) 295-9363

NPI assigned

Mar 23, 2023

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Pharmacy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1679529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679529600000",
    "number": "1053014753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 MARGARET ST",
            "city": "MONSON",
            "state": "MA",
            "postal_code": "010579416",
            "telephone_number": "413-297-3168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 N MAIN ST",
            "city": "WHITE RIVER JUNCTION",
            "state": "VT",
            "postal_code": "050090001",
            "telephone_number": "802-295-9363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAISURE",
        "first_name": "MACKENZIE",
        "middle_name": "RENEE",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-23",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "ID",
            "license": "P10304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Kutz, PHD
• Ryan Gregory Labella, M. ED
• Mary Coppens Labrecque, NP
• Donald Lacey, MD
• Elizabeth Anne Laeo, NURSE PRACTITIONER
• Lisa Ann Lambert, MD
• Frank Landino, D.O.
• Jessica Lange, L.AC
• Kathleen Curtin Langille, RN
• Eileen Frances Lanza, LCMHC

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in White River Junction, VT
• Providers in White River Junction, VT by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.