Provider Demographics
NPI:1982266235
Name:JONES, MACKENZIE WEIS (DNP FNP-BC)
Entity Type:Individual
Prefix:
First Name:MACKENZIE
Middle Name:WEIS
Last Name:JONES
Suffix:
Gender:F
Credentials:DNP FNP-BC
Other - Prefix:
Other - First Name:MACKENZIE
Other - Middle Name:BYRNE
Other - Last Name:WEIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4000 SHIPYARD BLVD STE 120
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-6194
Mailing Address - Country:US
Mailing Address - Phone:910-399-4992
Mailing Address - Fax:
Practice Address - Street 1:4000 SHIPYARD BLVD STE 120
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-6194
Practice Address - Country:US
Practice Address - Phone:910-399-4992
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-07
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC266638163W00000X
NC5011935363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse