Provider Demographics
NPI:1609306778
Name:PRECHT, MACKENZIE CASHMAN (PA-C)
Entity Type:Individual
Prefix:
First Name:MACKENZIE
Middle Name:CASHMAN
Last Name:PRECHT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MACKENZIE
Other - Middle Name:CASHMAN
Other - Last Name:PAPE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1845
Mailing Address - Street 2:
Mailing Address - City:STATESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28687-1845
Mailing Address - Country:US
Mailing Address - Phone:704-873-4277
Mailing Address - Fax:
Practice Address - Street 1:3334 BOYLSTON HWY
Practice Address - Street 2:SUITE 20
Practice Address - City:MILLS RIVER
Practice Address - State:NC
Practice Address - Zip Code:28759
Practice Address - Country:US
Practice Address - Phone:828-694-8150
Practice Address - Fax:828-694-8151
Is Sole Proprietor?:No
Enumeration Date:2017-06-12
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-07280363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0010-07280OtherSTATE LICENSE