Provider Demographics
NPI:1477152866
Name:GLASSMACHER, MACKENZIE HAMILTON (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:MACKENZIE
Middle Name:HAMILTON
Last Name:GLASSMACHER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5023 PARKSIDE CT
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:20187-2432
Mailing Address - Country:US
Mailing Address - Phone:703-909-0743
Mailing Address - Fax:
Practice Address - Street 1:75 W LEE HWY
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20186-2149
Practice Address - Country:US
Practice Address - Phone:540-351-0662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-19
Last Update Date:2024-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024180139363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily