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NPI 1104780170

NPI 1104780170 : MACKENZIE ERIKA BURNS : MENOMONEE FALLS, WI

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General NPI Number Information
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    NPI Number           |    1104780170
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    Entity Type          |    Individual 
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    Provider Name        |    MACKENZIE ERIKA BURNS
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    12/12/2025
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    Last Update Date     |    12/12/2025
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Provider Practice Location Address
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    Address Line         |    N86W12999 NIGHTINGALE WAY 
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    City                 |    MENOMONEE FALLS
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    State                |    WI
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    Zip                  |    53051-2102
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    Country              |    US
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    Telephone            |    414-805-5690
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    7511 SUNNYVALE CT 
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    City                 |    MEQUON
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    State                |    WI
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    Zip                  |    53092-1800
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    Country              |    US
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    Telephone            |    414-719-0056
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    183500000X
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    Taxonomy Name        |    Pharmacist
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    License Number       |    2269840
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    License Number State |    WI
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