Provider Demographics
NPI:1144956509
Name:HUPP, MCKENZIE LYNN (APRN, CNP)
Entity type:Individual
Prefix:
First Name:MCKENZIE
Middle Name:LYNN
Last Name:HUPP
Suffix:
Gender:F
Credentials:APRN, CNP
Other - Prefix:
Other - First Name:MCKENZIE
Other - Middle Name:
Other - Last Name:BEAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1165
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:OH
Mailing Address - Zip Code:43725-6165
Mailing Address - Country:US
Mailing Address - Phone:740-432-7440
Mailing Address - Fax:
Practice Address - Street 1:2951 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-1406
Practice Address - Country:US
Practice Address - Phone:740-455-4925
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-28
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0031846363L00000X
OH0031846363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health