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Individual
ESSENCE SHANAE MACK
Active
Individual
ESSENCE SHANAE MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Taxonomy
Speciality
Code
Description
License number
State
163WM0102X
Maternal Newborn Registered Nurse
28217478A
IN
367A00000X
Advanced Practice Midwife
09000521A
IN
367A00000X
Advanced Practice Midwife
Primary
71017773A
IN
Other
Enumeration date
07/20/2022
Last updated
04/02/2026
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