Individual
MS. SHINEKA LATOYA MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
421 FAYETTEVILLE ST, RALEIGH, NC 27601-1792
(919) 726-3163
(919) 891-1614
Mailing address
PO BOX 603949, CHARLOTTE, NC 28260-3949
(919) 350-0351
(919) 350-7687
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
25081
SC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
5017301
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790370047
—
NC
Enumeration date
03/08/2021
Last updated
05/14/2026
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