Provider Demographics
NPI:1144851486
Name:QUIGLEY, MACKENZIE LARAE (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:MACKENZIE
Middle Name:LARAE
Last Name:QUIGLEY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 CAMPUS PL
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40299-2308
Mailing Address - Country:US
Mailing Address - Phone:502-253-4924
Mailing Address - Fax:
Practice Address - Street 1:2019 STATE ST
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-4921
Practice Address - Country:US
Practice Address - Phone:812-949-5700
Practice Address - Fax:812-949-5791
Is Sole Proprietor?:No
Enumeration Date:2020-01-27
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP143550363LF0000X
IN71016740A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily