Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MS. KAKETHIA S. MACK, NURSE PRACTITIONER
Active Sole ProprietorMS. KAKETHIA S. MACK, NURSE PRACTITIONER is a Family Nurse Practitioner healthcare provider located in ELLENWOOD, Georgia. NPI 1346748837 is currently active in the NPPES registry. Verify at CMS.
Family Nurse Practitioner · ELLENWOOD, GA
Registration Details
- NPI Number
- 1346748837
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jan 30, 2018 (8.5184155227475 yrs)
- Last Updated
- Jul 2, 2018
- License
-
RN154797 (GA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
4124 BOSENBERRY WAYELLENWOOD, GA, 30294Browse GA providers · Browse ZIP 30294
- Phone
- 6784636568
- Fax
- 6784636568
- Primary Specialty
-
Family Nurse Practitioner
363LF0000X
Other Family Nurse Practitioner Providers in ELLENWOOD, GA
| Name | Credential | NPI |
|---|---|---|
| MRS. TERRILYN D LEMONS | APRNP | 1336304682 |
| KATHLEEN C HAYNES | FNP | 1992065718 |
| SIAMECO CURTIS | NP-C | 1710386313 |
| TAMARIA DUNN | FNP-C | 1992108328 |
| TREVINO C SIMMONS | FNP | 1346797065 |
| SHALUNDRAH MCINTIRE | — | 1326588104 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.