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General NPI Number Information
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NPI Number | 1144851486
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Entity Type | Individual
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Provider Name | MACKENZIE LARAE QUIGLEY FNP-C
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Gender | Female
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Dates
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Enumeration Date | 01/27/2020
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Last Update Date | 08/04/2025
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Provider Practice Location Address
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Address Line | 2019 STATE ST
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City | NEW ALBANY
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State | IN
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Zip | 47150-4921
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Country | US
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Telephone | 812-949-5700
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Fax | 812-949-5791
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Provider Business Mailing Address
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Address Line | 1901 CAMPUS PL
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City | LOUISVILLE
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State | KY
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Zip | 40299-2308
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Country | US
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Telephone | 502-253-4924
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP143550
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 71016740A
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License Number State | IN
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