Provider Demographics
NPI:1598573115
Name:CAMLIN, MAKENZIE LYNN
Entity type:Individual
Prefix:
First Name:MAKENZIE
Middle Name:LYNN
Last Name:CAMLIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 S AND B FARM LN
Mailing Address - Street 2:
Mailing Address - City:SAINT STEPHEN
Mailing Address - State:SC
Mailing Address - Zip Code:29479-4037
Mailing Address - Country:US
Mailing Address - Phone:843-934-0657
Mailing Address - Fax:
Practice Address - Street 1:110 EXECUTIVE PKWY
Practice Address - Street 2:
Practice Address - City:MONCKS CORNER
Practice Address - State:SC
Practice Address - Zip Code:29461-3930
Practice Address - Country:US
Practice Address - Phone:843-899-9099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-28
Last Update Date:2024-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC272081163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse