MS. VICKIE ROCHELLE MACK NPI 1912088055

NPI Information

  • NPI: 1912088055
  • Provider Name: MS. VICKIE ROCHELLE MACK
  • Classification: Licensed Practical Nurse - 164W00000X
  • Entity Type: Individual
  • Address: 811 ALVAREDO ST
    JACKSON, MS
    ZIP 39204
  • Phone: (601) 372-8941

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NPI Details

MS. Vickie Rochelle Mack is a licensed practical nurse in Jackson, MS. The provider is a licensed practical nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. MS. Vickie Rochelle Mack NPI is 1912088055. 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:

811 ALVAREDO ST
JACKSON, MS
ZIP 39204-317
Phone: (601) 372-8941

The enumeration date for this NPI number is 10/17/2006 and was last updated on 7/9/2007.

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
1164W00000XLicensed Practical NurseP122165MISSISSIPPIYes

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
100770172MEDICAIDMISSISSIPPI

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: 11/21/2025

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