Mackenzie Marie Drury

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

320637 Issued in WI

Practice address

990 Spring Valley Rd
Highland, WI 53543-9710

Phone

(608) 574-4779

NPI assigned

Apr 21, 2017

Sex

Female

Sole proprietor

Yes

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1492732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492732800000",
    "number": "1104351725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "990 SPRING VALLEY RD",
            "city": "HIGHLAND",
            "state": "WI",
            "postal_code": "535439710",
            "telephone_number": "608-574-4779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 SPRING VALLEY RD",
            "city": "HIGHLAND",
            "state": "WI",
            "postal_code": "535439710",
            "telephone_number": "608-574-4779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRURY",
        "first_name": "MACKENZIE",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-21",
        "last_updated": "2017-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WI",
            "license": "320637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Denise Lea Bomkamp, R.N.
• Geana R Gaasch, MS, ATC
• Highland Ambulance Service
• Highland Chiropractic, LLC
• Highland School District
• Highland Springs Counseling, LLC

• Licensed Practical Nurse in Highland, WI
• Providers in Highland, WI by specialty
• Licensed Practical Nurse in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2017; 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.