Doctor Name: | DACIA WILSON MACKENZIE |
NPI Number: | 1144556564 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CRNA |
License Number: | R93755 |
Business Practice Address: | 9263 Medical Plaza Dr Ste E Charleston, SC - 294067112 |
Business Phone Number: | 8435721228 |
Business Fax Number: | 8775617564 |
Mailing Address: | 9263 Medical Plaza Dr, Ste E CHARLESTON |
State: | SC |
Postal Code: | 294067112 |
Phone Number: | 8435721228 |
Fax Number: | 8775617564 |
NPI Enumeration Date: | 10/20/2009 |
NPI Last Update Date: | 06/01/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | R93755 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | SC |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |