Individual provider · Type 1 NPI

Mackenzie Rae Beacom, APRN, CPNP

Pediatric Nurse Practitioner · St. Paul, MN

NPI number 1194555128 Active

Practice location

345 Smith Ave N
St. Paul, MN 55102-2346

Mailing address

5875 Teakwood Ln N Apt B
Plymouth, MN 55442-1590

Specialties and licenses

TaxonomyCodeLicense
Pediatric Nurse Practitioner Primary 363LP0200X11806 (MN)

Pediatric Nurse Practitioner: Definition to come...

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About NPI 1194555128

Mackenzie Rae Beacom, APRN, CPNP's National Provider Identifier is 1194555128, issued on Aug 5, 2024. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in St. Paul, MN. The record was last updated on Aug 5, 2024.