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Individual

ZELBESA VAILIIDA DAKUE MACK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
28 HADDINGTON RD, TIMONIUM, MD 21093-5719
(410) 961-0844
Mailing address
28 HADDINGTON RD, TIMONIUM, MD 21093-5719
(410) 961-0844

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
R137492
MD
363LA2200X
Adult Health Nurse Practitioner
Primary
R137492
MD
363LG0600X
Gerontology Nurse Practitioner
R137492
MD

Other

Enumeration date
05/13/2015
Last updated
08/19/2024
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