Provider Demographics
NPI:1215799572
Name:ROCKWELL, MAKENZI (PA-C)
Entity type:Individual
Prefix:
First Name:MAKENZI
Middle Name:
Last Name:ROCKWELL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MAKENZI
Other - Middle Name:
Other - Last Name:HOWARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:270 DOUGLAS BEND RD APT 6104
Mailing Address - Street 2:
Mailing Address - City:GALLATIN
Mailing Address - State:TN
Mailing Address - Zip Code:37066-5599
Mailing Address - Country:US
Mailing Address - Phone:360-591-4961
Mailing Address - Fax:
Practice Address - Street 1:555 HARTSVILLE PIKE
Practice Address - Street 2:
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066-2400
Practice Address - Country:US
Practice Address - Phone:615-328-8888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-23
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical