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Individual

KAITLIN MARIE MACK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CNP

Contact information

Practice address
800 MCCONNELL RD, COLUMBUS, OH 43214-3463
(614) 566-5019
Mailing address
3600 S OLD 3C HWY, GALENA, OH 43021-9518
(440) 864-5120

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APRN.CNP.021460
OH

Other

Enumeration date
09/05/2017
Last updated
09/05/2017
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