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Individual

MS. NANCY CAMILLE MACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
5901 E 7TH ST, LONG BEACH, CA 90822-5201
(562) 826-5412
Mailing address
615 MIRA MAR AVE, LONG BEACH, CA 90814-1621
(562) 434-1390

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
349515
CA
367500000X
Certified Registered Nurse Anesthetist
Primary
2453
CA

Other

Enumeration date
09/25/2006
Last updated
06/22/2022
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