Provider Demographics
NPI:1558079848
Name:DRIMEL, MACKENZIE MARIE (CNP)
Entity Type:Individual
Prefix:MRS
First Name:MACKENZIE
Middle Name:MARIE
Last Name:DRIMEL
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14001 RIDGEDALE DR
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55305-1753
Mailing Address - Country:US
Mailing Address - Phone:952-249-2000
Mailing Address - Fax:952-856-2237
Practice Address - Street 1:14001 RIDGEDALE DR
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55305-1753
Practice Address - Country:US
Practice Address - Phone:952-249-2000
Practice Address - Fax:952-856-2237
Is Sole Proprietor?:No
Enumeration Date:2022-11-07
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN9698363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health