Provider Demographics
NPI:1407999840
Name:MACKLIN, MARY K (APRN)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:K
Last Name:MACKLIN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
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Mailing Address - Street 1:141 COLBY CROSSING RD
Mailing Address - Street 2:
Mailing Address - City:HENNIKER
Mailing Address - State:NH
Mailing Address - Zip Code:03242-3587
Mailing Address - Country:US
Mailing Address - Phone:603-428-7978
Mailing Address - Fax:
Practice Address - Street 1:246 PLEASANT ST
Practice Address - Street 2:SUITE 103
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-2548
Practice Address - Country:US
Practice Address - Phone:603-224-6070
Practice Address - Fax:603-224-6094
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2009-12-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH023423-23-05363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health