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NPI Code Detail

MEDICARE: MACKENZIE CUNNINGHAM

MEDICARE: MACKENZIE CUNNINGHAM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1175T00000XPeer Specialist

General Provider Information

NPI Number : 1386463461
Entity Type Code : Individual
Provider Name (Legal Business Name) : MACKENZIE CUNNINGHAM
Provider Business Mailing Address
First Line : 934 S MAIN ST
Second Line :
City : LAYTON
State : UT
Zip : 84041-7135
Country : US
Telephone Number : 801-773-7060
Fax Number :
Provider Business Practice Location Address
First Line : 934 S MAIN ST
Second Line :
City : LAYTON
State : UT
Zip : 84041-7135
Country : US
Telephone Number : 801-773-7060
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/07/2024
Last Update Date : 03/13/2026

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Directions to “ MACKENZIE CUNNINGHAM ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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