Michele M Mackenzie, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

70449 Issued in WV

Practice address

5515 Peach St
Erie, PA 16509-2603

Phone

(814) 864-4031

NPI assigned

Jul 12, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Michele M Larson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

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

• United Hospital Center, Inc.

  • Pain Medicine (Anesthesiology) Physician
  • Bridgeport, WV
  • NPI 1376590786
  NPD (past)

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

{
    "created_epoch": "1184198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229040000000",
    "number": "1548469307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 HARDSCRABBLE BLVD",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165052704",
            "telephone_number": "814-838-3793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5515 PEACH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165092603",
            "telephone_number": "814-864-4031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKENZIE",
        "first_name": "MICHELE",
        "middle_name": "M",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-12",
        "last_updated": "2008-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WV",
            "license": "70449",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN331682L",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELE",
            "last_name": "LARSON",
            "middle_name": "M",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Stanley Michael Maciejewski, DMD
• Lorri W Macisaac, SLP
• Roman Mack
• Angela Mackay, PT, DPT
• Katie Elizabeth Mackenzie
• Kaitlyn Mackey, PA-C
• Richard Alan Macklin, DO
• Courtney Mackowski, DPT
• Stephanie Macmurtrie, LPC
• Jessica Borrero Macrino, LPC

• Certified Registered Nurse Anesthetist in Erie, PA
• Providers in Erie, PA by specialty
• Certified Registered Nurse Anesthetist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2008; 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.