Provider Demographics
NPI:1144947904
Name:MCKERNAN, MAKENZIE ANN (WHNP)
Entity type:Individual
Prefix:MRS
First Name:MAKENZIE
Middle Name:ANN
Last Name:MCKERNAN
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:MS
Other - First Name:MAKENZIE
Other - Middle Name:ANN
Other - Last Name:WINSLOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:WHNP
Mailing Address - Street 1:16 THIRD STREET AHMC OB/GYN & MIDWIFERY
Mailing Address - Street 2:SUITE C
Mailing Address - City:MALONE
Mailing Address - State:NY
Mailing Address - Zip Code:12953
Mailing Address - Country:US
Mailing Address - Phone:518-481-2896
Mailing Address - Fax:518-481-2895
Practice Address - Street 1:16 THIRD STREET UVMHN ALICE HYDE MEDICAL CENTER OB/GYN
Practice Address - Street 2:SUITE C
Practice Address - City:MALONE
Practice Address - State:NY
Practice Address - Zip Code:12953
Practice Address - Country:US
Practice Address - Phone:518-481-2896
Practice Address - Fax:518-481-2895
Is Sole Proprietor?:No
Enumeration Date:2022-10-24
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT026.0142363163W00000X
NY421700363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse