ANGELIA MACK NPI 1871901967

NPI Information

NPI: 1871901967
Provider Name: ANGELIA MACK
Classification: Registered Nurse - 163WP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

Address:
1907 1/2 SEMPLE AVE
SAINT LOUIS, MO
ZIP 63112
Phone: (314) 303-9901
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Angelia Mack is a psychiatric/mental health registered nurse in Saint Louis, MO. Angelia Mack NPI is 1871901967. 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:

1907 1/2 SEMPLE AVE
SAINT LOUIS, MO
ZIP 63112-307
Phone: (314) 303-9901

The enumeration date for this NPI number is 8/1/2014 and was last updated on 8/1/2014.

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	163WP0808X	Registered Nurse	Psychiatric/Mental Health	1999135071	MISSOURI	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1013215128	MEDICAID	MISSOURI

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: 11/14/2023

NPI Synchronization or Removal

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