KIMBERLY RENEE MACK APN NPI 1154956001

NPI Information

NPI: 1154956001
Provider Name: KIMBERLY RENEE MACK, APN
Classification: Nurse Practitioner - 363LA2200X
Entity Type: Individual

Specialization: Adult Health

PECOS Registration: Yes

Address:
321 E BROAD ST
GIBBSTOWN, NJ
ZIP 08027
Phone: (856) 423-2790
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Kimberly Renee Mack, APN is an adult health nurse practitioner in Gibbstown, NJ. Kimberly Renee Mack, APN NPI is 1154956001. The provider is registered as an individual entity type and is a multi-specialty group.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

321 E BROAD ST
GIBBSTOWN, NJ
ZIP 08027-007
Phone: (856) 423-2790

The NPI 1154956001 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/10/2020 and was last updated on 3/10/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363L00000X	Nurse Practitioner		26NJ01024800	NEW JERSEY	No
2	363LA2100X	Nurse Practitioner	Acute Care	26NJ01024800	NEW JERSEY	No
3	363LG0600X	Nurse Practitioner	Gerontology	26NJ01024800	NEW JERSEY	No
4	363LA2200X	Nurse Practitioner	Adult Health	26NJ01024800	NEW JERSEY	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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