MEDICARE: MACKENZIE KATE POWELL CNM

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
1	367A00000X	Advanced Practice Midwife	RN2329792	MA

General Provider Information

NPI Number	:	1679037204
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MACKENZIE KATE POWELL CNM

Provider Business Mailing Address
First Line	:	330 MOUNT AUBURN ST # 2
Second Line	:
City	:	CAMBRIDGE
State	:	MA
Zip	:	02138-5597
Country	:	US
Telephone Number	:	617-499-5741
Fax Number	:	617-499-5620

Provider Business Practice Location Address
First Line	:	330 MOUNT AUBURN ST FL 1
Second Line	:
City	:	CAMBRIDGE
State	:	MA
Zip	:	02138-5502
Country	:	US
Telephone Number	:	617-499-5151
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/28/2019
Last Update Date	:	06/04/2026

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