Mackenzie Jacquelyn Blust (NPI# 1346707841, PAC ID# 2860724853) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1346707841 |
| PAC ID by PECOS | 2860724853 |
| Professional Enrollment ID | I20191023003709 |
| Full Name | Mackenzie Jacquelyn Blust |
| Organization Legal Name | LA PORTE CLINIC COMPANY LLC |
| Address |
304 Detroit St La Porte IN 46350-2497 |
| Phone Number | 2193253770 |
| Gender | F |
| Graduation Year | 2018 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 0446558357 |
| Number of Group Practice Members | 64 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 104 E Culver Rd, Knox, IN 46534-2241 | LA PORTE CLINIC COMPANY LLC | |
| 304 Detroit St, La Porte, IN 46350-2497 | 2193253770 | LA PORTE CLINIC COMPANY LLC |
| Organization Legal Name | LA PORTE CLINIC COMPANY LLC |
| Physicians | 85 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sylvia Oudhuis | Nurse Practitioner | La Porte Clinic Company LLC | 400 Legacy Plz W, La Porte, IN 46350-5296 |
| Dustin T Simcoe | Physician Assistant | La Porte Clinic Company LLC | 500 Legacy Plz W, La Porte, IN 46350-5254 |
| Diana M Correll | Physician Assistant | La Porte Clinic Company LLC | 304 Detroit St, La Porte, IN 46350-2497 |
| Megan L Vermilyer | Nurse Practitioner | La Porte Clinic Company LLC | 1509 State St, La Porte, IN 46350-3115 |
| Sarah D Knapp | Nurse Practitioner | La Porte Clinic Company LLC | 3777 N Frontage Rd, Michigan City, IN 46360-7695 |
| Wendy R Dutcher | Nurse Practitioner | La Porte Clinic Company LLC | 400 Teegarden St, La Porte, IN 46350-3175 |
| Jennifer K Vanmeter | Certified Nurse Midwife (cnm) | La Porte Clinic Company LLC | 601 W Kieffer Rd, Michigan City, IN 46360-9599 |
| Sandra L Ringer | Clinical Social Worker | La Porte Clinic Company LLC | 104 E Culver Rd, Knox, IN 46534-2241 |
| Christopher A Conn | General Surgery | La Porte Clinic Company LLC | 600 Legacy Plz W, La Porte, IN 46350-5268 |
| Joseph R Arulandu | Internal Medicine | La Porte Clinic Company LLC | 7002 W Johnson Rd, La Porte, IN 46350-8289 |
| Street Address |
304 DETROIT ST |
| City | LA PORTE |
| State | IN |
| Zip | 46350-2497 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Diana M Correll | Physician Assistant | La Porte Clinic Company LLC | 304 Detroit St, La Porte, IN 46350-2497 |
| Neil W Wangstrom | Otolaryngology | La Porte Clinic Company LLC | 304 Detroit St, La Porte, IN 46350-2497 |
| Jessica L Barr | Qualified Audiologist | La Porte Clinic Company LLC | 304 Detroit St, La Porte, IN 46350-2497 |
| Jessie B Batchelor | Audiologist | La Porte Clinic Company LLC | 304 Detroit St, La Porte, IN 46350-2497 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kayla Rae Nebelsick | Obstetrics/gynecology | Franciscan Physician Network | 309 W Johnson Rd, La Porte, IN 46350-1943 |
| Nancy Hoback | Clinical Social Worker | 245 W Johnson Rd, Suite 2, La Porte, IN 46350-2026 | |
| Amer Mahmud Kazi | Neurology | 286 W Johnson Rd E, Indiana Pain and Spine Clinic, Laporte, IN 46350-2060 | |
| Mary Beth Schramlin | Clinical Social Worker | 2626 N State Rd 39, Suite 4, La Porte, IN 46350-2074 | |
| Mark C Grant | Chiropractic | 611 Pine Lake Ave, Laporte, IN 46350-2318 | |
| Dennis L Sommer | Optometry | 316 Pine Lake Ave, La Porte, IN 46350-3061 | |
| Lori A Truesdell | Clinical Social Worker | 318 Pine Lake Ave, Laporte, IN 46350-3061 | |
| Irene Torres | Nurse Practitioner | Minuteclinic Diagnostics of Indiana LLC | 1407 Lincolnway, La Porte, IN 46350-3105 |
| Kristin S Miers | Nurse Practitioner | Minuteclinic Diagnostics of Indiana LLC | 1407 Lincolnway, La Porte, IN 46350-3105 |
| Hassan Usmani | Podiatry | Podiatric Medical Associates PC | 1501 State St, La Porte, IN 46350-3115 |
| Find all physicians in zip 46350 | |||
| City | LA PORTE |
| Zip Code | 46350 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | LA PORTE + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Mackenzie Jacquelyn Blust.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.