Individual
MRS. ALISHA NOEL MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN
Contact information
Practice address
813 S MICHIGAN ST, SOUTH BEND, IN 46601-3102
(574) 283-5572
(574) 283-5571
Mailing address
813 S MICHIGAN ST, SOUTH BEND, IN 46601-3102
(574) 283-5572
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
28169564A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200962090
—
IN
Enumeration date
06/30/2009
Last updated
09/28/2011
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