| Doctor Name: | JENNIFER K MACKEY |
| NPI Number: | 1013321835 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CNP |
| License Number: | RN 332567 |
| Business Practice Address: | 6770 Mayfield Rd # 421 Hc40 Mayfield Heights, OH - 441242299 |
| Business Phone Number: | 4403127689 |
| Business Fax Number: | 4404497715 |
| Mailing Address: | 6770 Mayfield Rd # 421, Hc40 MAYFIELD HEIGHTS |
| State: | OH |
| Postal Code: | 441242299 |
| Phone Number: | 4403127689 |
| Fax Number: | 4404497715 |
| NPI Enumeration Date: | 06/19/2014 |
| NPI Last Update Date: | 06/19/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | RN 332567 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OH |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |