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NPI Code Detail

MEDICARE: MACKENZIE TARGETT PMHNP-BC

MEDICARE: MACKENZIE TARGETT PMHNP-BC
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
1163WP0808XPsychiatric/Mental Health Registered NurseRN2363139MA
2363LP0808XPsychiatric/Mental Health Nurse PractitionerRN2363139MA

General Provider Information

NPI Number : 1972220598
Entity Type Code : Individual
Provider Name (Legal Business Name) : MACKENZIE TARGETT PMHNP-BC
Provider Business Mailing Address
First Line : 35 VILLAGE RD STE 100
Second Line :
City : MIDDLETON
State : MA
Zip : 01949-1238
Country : US
Telephone Number : 617-958-2726
Fax Number : 781-214-3174
Provider Business Practice Location Address
First Line : 35 VILLAGE RD STE 100
Second Line :
City : MIDDLETON
State : MA
Zip : 01949-1238
Country : US
Telephone Number : 617-958-2726
Fax Number : 781-214-3174
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2022
Last Update Date : 02/19/2026

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Directions to “ MACKENZIE TARGETT PMHNP-BC” Practice Location

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