Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MRS. KELLY LEIGH MACK, PA-C
ActiveMRS. KELLY LEIGH MACK, PA-C is a Medical Physician Assistant healthcare provider located in PRINCE FREDERICK, Maryland. NPI 1396813960 is currently active in the NPPES registry. Verify at CMS.
Medical Physician Assistant · PRINCE FREDERICK, MD
Registration Details
- NPI Number
- 1396813960
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Dec 1, 2006 (19.673987667589 yrs)
- Last Updated
- Aug 13, 2019
- Licenses
-
PA18061 (CA)PA07662 (TX)
Practice Information
- Address
-
995 N. PRINCE FREDERICK BLVDSUITE 204PRINCE FREDERICK, MD, 20678Browse MD providers · Browse ZIP 20678
- Phone
- 4105355855
- Fax
- 4105356574
- Primary Specialty
-
Medical Physician Assistant
363AM0700X
- Additional Specialty
- Medical Physician Assistant
Other Medical Physician Assistant Providers in PRINCE FREDERICK, MD
| Name | Credential | NPI |
|---|---|---|
| CHRISTINA A ATHENS | P.A. | 1457305682 |
| JOHN W. LEROY | — | 1295774438 |
| SAMANTHA L KEITER | PAC | 1700215431 |
| MR. KENNETH L FERRERA | PA-C | 1164899241 |
| STEPHANIE HICKCOX | PA-C | 1598276826 |
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.