Provider Demographics
NPI:1003483090
Name:RHOADES, MACKENZIE (APRN-CNP, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:MACKENZIE
Middle Name:
Last Name:RHOADES
Suffix:
Gender:F
Credentials:APRN-CNP, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:271 W LAKEVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1070
Mailing Address - Country:US
Mailing Address - Phone:614-596-4401
Mailing Address - Fax:
Practice Address - Street 1:815 W BROAD ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43222-1464
Practice Address - Country:US
Practice Address - Phone:614-717-0822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-08
Last Update Date:2025-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
OH530729163W00000X
OH0039352363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No163W00000XNursing Service ProvidersRegistered Nurse