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).
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 |
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 |
Address | Telephone Number | Fax Number |
---|---|---|
7590 Auburn Rd, Painesville, OH 440779176 | 4403758100 |
Street Address |
36060 EUCLID AVE |
City | WILLOUGHBY |
State | OH |
Zip Code | 44094-4656 |
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 |
Find all providers in the same location |
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 |
Find all providers in zip 44094 |
Taxonomy Code | 363LF0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Family |
Definition to come... |
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 |
City | WILLOUGHBY |
Zip Code | 44094 |
Please comment or provide details below to improve the information on DIANA LEE MACKENSEN.
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.