Individual
MRS. KELLY S MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN BC
Contact information
Practice address
6001 RESEARCH PARK BLVD, MADISON, WI 53719
(608) 232-3333
(608) 231-9011
Mailing address
7974 UW HEALTH CT, MIDDLETON, WI 53562-5531
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2791033
WI
Other
Enumeration date
03/30/2007
Last updated
04/28/2009
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