Individual
JENNIFER MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5904 HOLLY AVE NE, ALBUQUERQUE, NM 87113-2472
(505) 298-2505
(505) 298-2985
Mailing address
9201 MONTGOMERY BLVD NE STE 201, ALBUQUERQUE, NM 87111-2467
(505) 298-2505
(505) 298-2985
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
85353
NM
Other
Enumeration date
10/25/2016
Last updated
09/15/2025
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