DIANA LEE MACKENSEN


Address: 36060 Euclid Ave, Willoughby, OH 44094-4656
Phone: 4409539600

DIANA LEE MACKENSEN (NPI# 1629575329) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1629575329
Entity Type Individual
Full Name DIANA LEE MACKENSEN
Credential FNP-C
Practice Address 36060 Euclid Ave
Willoughby
OH 44094-4656
Mailing Address 5699 Charmar Dr
Mentor
OH 44060-1902
Practice Telephone 4409539600
Mailing Telephone 4407499456
Enumeration Date 2018-04-09
Last Update Date 2018-04-09
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LF0000X Nurse Practitioner
Specialization: Family
APRN.CNP.021979 OH Physician Assistants & Advanced Practice Nursing Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
7590 Auburn Rd, Painesville, OH 440779176 4403758100

Office Location

Street Address 36060 EUCLID AVE
City WILLOUGHBY
State OH
Zip Code 44094-4656

Providers in the same location

NPI Name Taxonomy Address Enumeration
1649252743 Jaye E Benjamin Dermatology 36060 Euclid Ave, Suite 202, Willoughby, OH 44094-4656 2005-11-16
1700350923 Amelia Ann Wilmot Physician Assistant 36060 Euclid Ave, Willoughby, OH 44094-4656 2019-01-22
1528494531 Sherry Nicole Palmer Nurse Practitioner 36060 Euclid Ave, Suite 204, Willoughby, OH 44094-4656 2013-09-23
1518224906 Matthew M Keum, M.d., Inc Pain Medicine 36060 Euclid Ave, Suite 101, Willoughby, OH 44094-4656 2012-04-23
1720389380 Institute for Spine Inc Orthopaedic Surgery 36060 Euclid Ave, Ste# 101, Willoughby, OH 44094-4656 2010-11-12
1932434289 Outreach Professional Services, Inc. Surgery 36060 Euclid Ave, Suite 107, Willoughby, OH 44094-4656 2009-10-05
1508028135 Helge Ulrich Simon M.d Internal Medicine 36060 Euclid Ave, 107, Willoughby, OH 44094-4656 2008-06-25
1003090689 Lake Hospital System, Inc. Orthopaedic Surgery 36060 Euclid Ave, Suite 203, Willoughby, OH 44094-4656 2007-12-19
1144336470 William J Petraiuolo Surgery 36060 Euclid Ave, Suite 204, Willoughby, OH 44094 2006-08-21
1194747451 Steven P Combs Orthopaedic Surgery 36060 Euclid Ave, Suite 104, Willoughby, OH 44094-4656 2006-07-24
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1518574367 Bj's Wholesale Club Inc. Eyewear Supplier (Equipment, not the service) 36596 Euclid Ave, Willoughby, OH 44094 2020-09-25
1679111322 Megan King Nurse Practitioner 4078 Erie Street, Unit B, Willoughby, OH 44094 2019-12-12
1124661525 Mind and Body Infusion Therapies, LLC Clinic/Center 9264 Chillicothe Rd., Unit #2, Kirtland, OH 44094 2019-10-18
1679125637 Christina Maria Chandler Family Medicine 39021 Signature Circle, Willoughby, OH 44094 2019-07-10
1467920595 Rachel Curry Specialist/Technologist 53400 Euclid Ave., Apt. E-102, Willoughby, OH 44094 2018-11-07
1437649753 Katie Lauren Greenaway Registered Nurse 5103 Robinhood Dr, Willoughby, OH 44094 2018-05-11
1003346131 Heather Marie Hayes Licensed Practical Nurse 38882 Mentor Ave., Willoughby, OH 44094 2017-06-12
1609305028 Ann Marie Mason Counselor 38882 Mentor Avenue, Willoughby, OH 44094 2017-06-08
1285173005 Mattie Diann Towns-scott Social Worker 34950 Chardon Road, Bldg 2, Suite 210, Willoughby Hills, OH 44094 2017-02-13
1447797329 Therese Benz General Acute Care Hospital 96000 Euclid Ave., Willoughby, OH 44094 2017-01-30
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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1679111322 Megan King Nurse Practitioner 4078 Erie Street, Unit B, Willoughby, OH 44094 2019-12-12
1366906745 Dina Aurslanian Nurse Practitioner 38150 Tamarac Blvd Apt 134, Willoughby, OH 44094-3430 2019-01-30
1639652027 Tiffany Reichert Nurse Practitioner 37221 Grove Ave Apt 302, Willoughby, OH 44094-5958 2018-09-11
1497233985 Pamela Petro Nurse Practitioner 36001 Euclid Ave Ste C19, Willoughby, OH 44094-4651 2018-08-06
1538160403 Damon M Boogaart Nurse Practitioner 2570 Som Center Rd, Willoughby, OH 44094-9607 2005-08-02
1043781925 Shanon Lee Mekesa Ellis Nurse Practitioner 6005 Som Center Rd, Willoughby, OH 44094-9646 2018-12-17
1740710573 Kelley Lynn Sega Nurse Practitioner 36000 Euclid Ave, Willoughby, OH 44094-4625 2017-06-14
1003264060 Samantha C Cole Nurse Practitioner 6005 Som Center Rd, Willoughby, OH 44094-9646 2016-06-01
1356709265 Shannon Bailey Nurse Practitioner 36000 Euclid Ave, Willoughby, OH 44094-4625 2016-02-05
1003282328 Robert William Jonath Nurse Practitioner 36000 Euclid Avenue, Willoughby, OH 44094 2015-08-20
Find all providers in WILLOUGHBY

Competitor

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City WILLOUGHBY
Zip Code 44094

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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