Provider Demographics
NPI:1811578198
Name:SCURFIELD, MACKENZIE MARIE (CNM)
Entity Type:Individual
Prefix:
First Name:MACKENZIE
Middle Name:MARIE
Last Name:SCURFIELD
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:MACKENZIE
Other - Middle Name:MARIE
Other - Last Name:DWYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM
Mailing Address - Street 1:3138 MCDONALD
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49083-9343
Mailing Address - Country:US
Mailing Address - Phone:608-469-5205
Mailing Address - Fax:
Practice Address - Street 1:601 JOHN ST STE N1200A
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49007-5341
Practice Address - Country:US
Practice Address - Phone:269-341-7979
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-18
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704330106367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife