Individual
RACHEL THERESE MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
4704316510
MI
363L00000X
Nurse Practitioner
6972253-8900
UT
363LN0000X
Neonatal Nurse Practitioner
Primary
4704316510
MI
363LN0000X
Neonatal Nurse Practitioner
NP-1529A
ID
Other
Enumeration date
10/16/2013
Last updated
07/13/2022
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