Healthcare Provider Details

I. General information

NPI: 1225943467
Provider Name (Legal Business Name): MACKENZIE SHAYNE LYNCH BSN, RN, SAFE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

282 WASHINGTON ST
HARTFORD CT
06106-3322
US

IV. Provider business mailing address

13 WINDCREST DR
GRANBY CT
06035-2425
US

V. Phone/Fax

Practice location:
  • Phone: 860-545-9000
  • Fax:
Mailing address:
  • Phone: 860-993-7505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number220988
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: