Provider Demographics
NPI:1689358780
Name:WALDRAN, MACKENZIE (PA)
Entity type:Individual
Prefix:
First Name:MACKENZIE
Middle Name:
Last Name:WALDRAN
Suffix:
Gender:F
Credentials:PA
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Other - Credentials:
Mailing Address - Street 1:17 GREENWICH CT
Mailing Address - Street 2:
Mailing Address - City:OAKMONT
Mailing Address - State:PA
Mailing Address - Zip Code:15139-1170
Mailing Address - Country:US
Mailing Address - Phone:989-798-7821
Mailing Address - Fax:
Practice Address - Street 1:2775 MOSSIDE BLVD
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-2760
Practice Address - Country:US
Practice Address - Phone:412-357-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-12
Last Update Date:2025-07-31
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical