Individual
CARLY MACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
1503 LANSDOWNE AVE STE 3002, DARBY, PA 19023-1308
(610) 237-4995
Mailing address
1714 LATONA ST, PHILADELPHIA, PA 19146-3028
(304) 794-9568
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
SP026546
PA
Other
Enumeration date
11/08/2022
Last updated
05/01/2023
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