Provider Demographics
NPI:1639996275
Name:NIGHTINGALE CAUM, MACKENZIE (NP)
Entity type:Individual
Prefix:
First Name:MACKENZIE
Middle Name:
Last Name:NIGHTINGALE CAUM
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4010 AERIAL WAY
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97402-9757
Mailing Address - Country:US
Mailing Address - Phone:541-687-6353
Mailing Address - Fax:
Practice Address - Street 1:4010 AERIAL WAY # 97402
Practice Address - Street 2:BARGER CLINIC
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97402-9757
Practice Address - Country:US
Practice Address - Phone:541-687-6353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-24
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201341574RN163WH1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH1000XNursing Service ProvidersRegistered NurseHospice