Provider Demographics
NPI:1023617594
Name:COTTON, MCKENZIE LAUREN (APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:MCKENZIE
Middle Name:LAUREN
Last Name:COTTON
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1665 MULBERRY GROVE LN
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72032-4532
Mailing Address - Country:US
Mailing Address - Phone:501-339-0133
Mailing Address - Fax:
Practice Address - Street 1:1065 SKYLINE DR
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72032-3530
Practice Address - Country:US
Practice Address - Phone:501-499-6222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-25
Last Update Date:2020-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR126199363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily