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General NPI Number Information
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NPI Number | 1164378782
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Entity Type | Individual
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Provider Name | MAKENZIE WHITLEY DNP, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 03/06/2026
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Last Update Date | 03/06/2026
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Provider Practice Location Address
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Address Line | 620 DR CALVIN JONES HWY STE 208
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City | WAKE FOREST
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State | NC
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Zip | 27587-3108
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Country | US
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Telephone | 984-204-8801
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Fax |
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Provider Business Mailing Address
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Address Line | 11386 CAMP CHARLES RD
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City | BAILEY
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State | NC
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Zip | 27807-8866
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Country | US
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Telephone | 252-299-3070
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 5024066
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License Number State | NC
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