Gustafson, Mackenzie
Gustafson, Mackenzie is an sole proprietor health care provider with primary practice located at 414 Shoup Ave W Ste B , Twin Falls ID 83301-5042. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Gustafson, Mackenzie can be contacted via phone (208) 814-9100.Contact Information
Primary practice address
414 Shoup Ave W Ste B
Twin Falls ID 83301-5042
Phone: (208) 814-9100
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health | 363LP0808X | 59468 | Idaho |
Profile Details
| NPI number | 1669101234 |
|---|---|
| LBN Legal business name | Gustafson, Mackenzie |
| Credentials | PMHNP |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 8th, 2022 |
| Last updated | Aug 19th, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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