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General NPI Number Information
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NPI Number | 1386462455
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Entity Type | Individual
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Provider Name | KIRA ANN MACKAY PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 09/28/2024
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Last Update Date | 09/28/2024
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Provider Practice Location Address
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Address Line | 108 MAIN ST S
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City | MINOT
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State | ND
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Zip | 58701-3914
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Country | US
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Telephone | 701-852-5070
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Fax | 877-712-6895
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Provider Business Mailing Address
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Address Line | 603 11TH ST NW
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City | MINOT
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State | ND
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Zip | 58703-2159
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Country | US
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Telephone | 701-340-5236
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 201114
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License Number State | ND
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