MRS. ALICIA MAE MACK FNP-C NPI 1225523004

NPI Information

NPI: 1225523004
Provider Name: MRS. ALICIA MAE MACK, FNP-C
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
212 S. 4TH ST. SUITE 301
SPECTRA HEALTH
GRAND FORKS, ND
ZIP 58201
Phone: (701) 757-2100
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MRS. Alicia Mae Mack, FNP-C is a family nurse practitioner in Grand Forks, ND with 6 years of experience. MRS. Alicia Mae Mack, FNP-C NPI is 1225523004. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

212 S. 4TH ST. SUITE 301
SPECTRA HEALTH
GRAND FORKS, ND
ZIP 58201
Phone: (701) 757-2100
Fax: (701) 757-2813

The NPI 1225523004 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 6/25/2018 and was last updated on 2/24/2020.

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	163W00000X	Registered Nurse		2344340	MINNESOTA	No
2	163W00000X	Registered Nurse		R39910	NORTH DAKOTA	No
3	363LF0000X	Nurse Practitioner	Family	R39910	NORTH DAKOTA	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: 4/28/2024

NPI Synchronization or Removal

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