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Individual

ALLISON J MACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNP

Contact information

Practice address
3333 BURNET AVE, ML 2011, CINCINNATI, OH 45229-3026
(513) 636-4506
(513) 636-7247
Mailing address
3333 BURNET AVE, ML 2011, CINCINNATI, OH 45229-3026
(513) 636-4506
(513) 636-7247

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN.CNP.06918
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2411867
OH
05
78014909
KY
Enumeration date
05/30/2006
Last updated
03/29/2018
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