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Individual

MS. KATHLEEN THERESA MACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
1560 GARRETT RD, UPPER DARBY, PA 19082-4516
(610) 638-1076
(610) 638-1085
Mailing address
1560 GARRETT RD, UPPER DARBY, PA 19082-4516
(610) 638-1076
(610) 638-1085

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
SP008049
PA

Other

Enumeration date
11/02/2008
Last updated
05/13/2014
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