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General NPI Number Information
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NPI Number | 1215542378
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Entity Type | Individual
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Provider Name | ANNA MICHELLE MACKIE CNM
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Gender | Female
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Dates
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Enumeration Date | 09/14/2020
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Last Update Date | 09/14/2020
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Provider Practice Location Address
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Address Line | 1234 HUFFMAN MILL RD
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City | BURLINGTON
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State | NC
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Zip | 27215-8777
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Country | US
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Telephone | 336-538-1234
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Fax |
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Provider Business Mailing Address
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Address Line | 129 GOLDENROD CT
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City | BURLINGTON
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State | NC
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Zip | 27215-7036
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Country | US
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Telephone | 910-381-5362
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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 | 176B00000X
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Taxonomy Name | Midwife
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License Number | CNM767
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License Number State | NC
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