Mackenzie Lanman

Individual provider Active NPI Athletic Trainer · Centerville, IN

NPI 1619711041 · NPPES record last updated May 14, 2026

Key facts

NPI
1619711041
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
Practice address
7683 Tice Rd
Centerville, IN 47330-9720
Phone
(765) 960-6011
NPI assigned
Jun 20, 2024
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X IN Yes

Addresses

Primary practice location

7683 Tice Rd
Centerville, IN 47330-9720

Mailing address

7683 Tice Rd
Centerville, IN 47330-9720

Other providers in Centerville, IN

All providers in Centerville, IN · Athletic Trainer in Indiana

Sources for this page

Verify at the official NPI Registry.