Mackenzie Prince, APRN FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP126759 Issued in TX

Practice address

717 Magnolia St
Jacksboro, TX 76458-1111

Phone

(940) 567-6633

NPI assigned

Aug 15, 2014

Last updated

Oct 6, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lovelace Health System LLC

  • Rural Health Clinic/Center
  • Roswell, NM
  • NPI 1609273283
  NPD (past)

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

{
    "created_epoch": "1408060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475712000000",
    "number": "1144629197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1917 N LAKE DR",
            "city": "WEATHERFORD",
            "state": "TX",
            "postal_code": "760856968",
            "telephone_number": "210-218-3193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 MAGNOLIA ST",
            "city": "JACKSBORO",
            "state": "TX",
            "postal_code": "764581111",
            "telephone_number": "940-567-6633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRINCE",
        "first_name": "MACKENZIE",
        "credential": "APRN FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-15",
        "last_updated": "2016-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP126759",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "532811",
            "primary": false
        },
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "TX",
            "license": "532811",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nortex Medical Equipment Center,Inc. (Nortex Medical Pharmacy)
• Brittany Leigh Norvill
• Lara Marina Oakes, MD
• Teresa Lynn Pate, COTA
• Physician Services of Jacksboro PA
• Kalyn Qualls, PHARM.D.
• Robert Cooper, M.D., PA
• Eric Vaughn Rothe, LPC
• Brent Shepherd, M.D.
• Rachelle Stottlemyre, FNP-C

• Family Nurse Practitioner in Jacksboro, TX
• Providers in Jacksboro, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.