MACKENZIE E DOUGLASS

SANTA CRUZ, CA
NPI1922446889
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy367A00000X Advanced Practice Midwife
(Licence: CA  95212458)
Additional Taxonomies367A00000X Advanced Practice Midwife
(Licence: OH  APRN.CNM.019342)
367A00000X Advanced Practice Midwife
(Licence: IL  209.010345)
Enumeration Date2013-06-12
Last Update Date2020-07-31
Business Address
MACKENZIE E DOUGLASS MSN, CNM
1505 SOQUEL DR STE 1
SANTA CRUZ, CA 95065-1716
Phone number: 831-465-5440
Mailing Address
MACKENZIE E DOUGLASS MSN, CNM
3400 DATA DR ATTN CREDENTIALING/PAYER ENROLLMENT
RANCHO CORDOVA, CA 95670-7956
Phone number: