National Provider Identifier

Theresa Mack, LPN

Theresa Mack, LPN is listed in the NPPES registry with a primary specialty of Licensed Practical Nurse in Rochester, NY and a listed phone number of (585) 317-7712.

NPI 1700171378Rochester, NYLicensed Practical Nurse

Profile Overview

NPI
1700171378
Provider Type
Individual
Primary Specialty
Licensed Practical Nurse
Enumeration Date
June 12, 2011
Last Updated
June 12, 2011

Practice Location

  • 394 Electric Ave
  • Rochester, NY 14613-1004

Phone: (585) 317-7712

Specialties

  • Licensed Practical Nurse (164W00000X)
Full Record
NPI
1700171378
Entity Type
Individual
Last Name
Mack
First Name
Theresa
Credential
LPN
Mailing Street Address
394 Electric Ave
Mailing City
Rochester
Mailing State
NY
Mailing ZIP Code
14613-1004
Mailing Country
US
Mailing Phone
(585) 317-7712
Practice Street Address
394 Electric Ave
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14613-1004
Practice Country
US
Practice Phone
(585) 317-7712
Enumeration Date
June 12, 2011
Last Updated
June 12, 2011
Sex
Female
Sole Proprietor
Yes
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Licensed Practical Nurse (164W00000X)