Provider Demographics
NPI:1114432309
Name:LAMB, MACKENZIE ERIN (NP)
Entity Type:Individual
Prefix:
First Name:MACKENZIE
Middle Name:ERIN
Last Name:LAMB
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4716 ALLIANCE BLVD STE 500
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-5386
Mailing Address - Country:US
Mailing Address - Phone:469-800-6000
Mailing Address - Fax:
Practice Address - Street 1:4716 ALLIANCE BLVD STE 500
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093
Practice Address - Country:US
Practice Address - Phone:469-800-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-09
Last Update Date:2018-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP134826363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care