Provider Demographics
NPI:1902502263
Name:MAYFIELD, MCKENZI LAYNE (PA)
Entity Type:Individual
Prefix:
First Name:MCKENZI
Middle Name:LAYNE
Last Name:MAYFIELD
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7550 HILLSIDE RD APT 2807
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79119-8340
Mailing Address - Country:US
Mailing Address - Phone:806-674-1066
Mailing Address - Fax:
Practice Address - Street 1:7550 HILLSIDE RD APT 2807
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79119-8340
Practice Address - Country:US
Practice Address - Phone:806-674-1066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-07
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty