KONSTANCE MACKIE (NPI# 1841802253) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841802253 |
| Entity Type | Individual |
| Full Name | KONSTANCE MACKIE |
| Practice Address |
100 Brewster Blvd Camp Lejeune NC 28547-2575 |
| Practice Telephone | 9104503589 |
| Enumeration Date | 2020-08-18 |
| Last Update Date | 2020-08-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
11007857 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NONE | NONE | 01 |
| Street Address |
100 BREWSTER BLVD |
| City | CAMP LEJEUNE |
| State | NC |
| Zip Code | 28547-2575 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588668982 | Pierce Overman | Family Medicine | 100 Brewster Blvd, Naval Hospital, Camp Lejeune, NC 28547-2538 | 2005-06-13 |
| 1275146417 | Kristi Lynn Dixon | Nurse Practitioner | 100 Brewster Blvd, Camp Lejeune, NC 28547-2575 | 2020-08-27 |
| 1003425117 | Jeremy Moore | Licensed Practical Nurse | 100 Brewster Blvd, Camp Lejeune, NC 28547-2575 | 2020-07-24 |
| 1801404546 | Erika Merite Papenfuss | Nurse Anesthetist, Certified Registered | 100 Brewster Blvd, Camp Lejeune, NC 28547-2575 | 2020-07-20 |
| 1306454244 | Devon Nicole Dan | Nurse Anesthetist, Certified Registered | 100 Brewster Blvd, Camp Lejeune, NC 28547-2575 | 2020-07-16 |
| 1851918957 | Uriah Nmn Paul | Nurse Anesthetist, Certified Registered | 100 Brewster Blvd, Camp Lejeune, NC 28547-2575 | 2020-07-06 |
| 1447876529 | Leslee Lynne Smith | Speech-Language Pathologist | 100 Brewster Blvd, Camp Lejeune, NC 28547-2575 | 2020-06-24 |
| 1356965727 | Haleigh Leister | Specialist/Technologist | 100 Brewster Blvd, Camp Lejeune, NC 28547-2575 | 2020-06-02 |
| 1407482045 | Shajaylyn Lee-combs | Student in an Organized Health Care Education/Training Program | 100 Brewster Blvd, Camp Lejeune, NC 28547-2575 | 2020-03-16 |
| 1477188324 | Randi Brenai Allen | Student in an Organized Health Care Education/Training Program | 100 Brewster Blvd, Camp Lejeune, NC 28547-2575 | 2020-03-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558906032 | Abigail Deemer | Physician Assistant | L Street, Bldg Hp-416, Camp Lejeune, NC 28547 | 2019-11-08 |
| 1407406267 | Michelle Ferricher | Nurse Practitioner | Naval Medical Center Pediatric Clinic, Nh-200 Recovery Way, Camp Lejeune, NC 28547 | 2019-09-13 |
| 1215595566 | Kayla L Torrez Chang | General Practice | Mcmh Fc 308, Hm Smith Boulevard, Camp Lejeune, NC 28547 | 2019-06-02 |
| 1699338442 | Amanda Leigh Jepsen | Military Health Care Provider | Naval Medical Center; 100 Brewster Blvd, Camp Lejeune, NC 28547 | 2019-04-17 |
| 1306336995 | Erik Reid King | Physician Assistant | F Street Bldg. Hp206, Camp Lejeune, NC 28547 | 2018-05-18 |
| 1114434032 | David John Mcdermott | Specialist/Technologist | Bldg. H1 Julian C Smith Rd., Camp Lejuene, NC 28547 | 2017-12-30 |
| 1235678434 | Nicolle Elizabeth Johnson | Occupational Therapist | 180 Hospital Corps Blvd., Camp Lejeune, NC 28547 | 2017-02-21 |
| 1427435585 | Naval Medical Center Camp Lejeune | Military/U.S. Coast Guard Pharmacy | Stone St. Extention, Bldg Nh200, Camp Lejeune, NC 28547 | 2015-04-28 |
| 1043634173 | Garrett Michael Wren | Obstetrics & Gynecology | Naval Medical Center, 100 Brewster Blvd, Camp Lejeune, NC 28547 | 2014-02-10 |
| 1245662436 | Samuel Maluil | Internal Medicine | Bldg 124 Wallace Creek, Camp Lejeunce, NC 28547 | 2013-07-30 |
| Find all providers in zip 28547 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407406267 | Michelle Ferricher | Nurse Practitioner | Naval Medical Center Pediatric Clinic, Nh-200 Recovery Way, Camp Lejeune, NC 28547 | 2019-09-13 |
| 1932623006 | Nichole Benson | Nurse Practitioner | 100 Brewster Blvd, C/o Pediatric Clinic, Camp Lejeune, NC 28547-2575 | 2017-08-01 |
| 1568770139 | Anna Marie Schwarz | Nurse Practitioner | 100 Brewster Blvd, 100 Brewster Blvd, Camp Lejeune, NC 28547-2538 | 2010-09-17 |
| 1386950921 | Kathryn Meredith Raabe Stewart | Nurse Practitioner | 100 Brewster Blvd, Camp Lejeune, NC 28547-2575 | 2010-08-20 |
| 1720059074 | Jerri Gray | Nurse Practitioner | 100 Brewster Blvd, Naval Hospital, Camp Lejeune, NC 28547-2538 | 2006-01-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811594732 | Megan Hoekstra | Nurse Practitioner | 8358 Six Forks Rd Ste 204, Raleigh, NC 27615-5093 | 2020-10-04 |
| 1639713118 | Holly Hattler Barber | Nurse Practitioner | Unc Dept of Pediatrics 030 Macnider Hall Cb 7231, Chapel Hill, NC 27599-0001 | 2019-10-29 |
| 1437709565 | Molly Benson Miller | Nurse Practitioner | 101 Manning Dr Cb 7236, Chapel Hill, NC 27599-7236 | 2019-09-20 |
| 1548814072 | Ashley Goodwin Friddle | Nurse Practitioner | 802 Green Valley Rd Ste 210, Greensboro, NC 27408-7099 | 2019-08-01 |
| 1740743129 | Jennifer W Farrow | Nurse Practitioner | 940 Se Cary Pkwy Ste 200, Cary, NC 27518-7417 | 2019-04-11 |
| 1538641147 | Taylor Rippy | Nurse Practitioner | 2304 Delaney Ave, Wilmington, NC 28403-6013 | 2018-08-30 |
| 1427544931 | Sheila L Mason | Nurse Practitioner | Wfbmc 1 Medical Center Blvd, Winston Salem, NC 27157-0001 | 2018-07-09 |
| 1770099319 | Jillian Hernandez Sprague | Nurse Practitioner | 101 E Matthews St Ste 800, Matthews, NC 28105-5374 | 2017-12-19 |
| 1427587625 | Amanda Register | Nurse Practitioner | 110 E Park Dr, Beulaville, NC 28518-6916 | 2017-06-09 |
| 1225562812 | Kathryn Beaulieu Fournier | Nurse Practitioner | 16747 Us Highway 17 N Ste 114, Hampstead, NC 28443-3086 | 2017-04-20 |
| Find all providers with the same taxonomy | ||||
| City | CAMP LEJEUNE |
| Zip Code | 28547 |
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| 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.