Kelly Mack, PA-C
NPI 1396813960 belongs to Kelly Mack, PA-C, a medical physician assistant with a practice location in Prince Frederick, MD. The NPI was issued on December 1, 2006, and the record was last updated in NPPES on August 13, 2019. The record lists 2 taxonomy codes.
This record hasn't been updated in NPPES since 2019. Details may be out of date.
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | PA07662 (TX) |
| Medical Physician Assistant | 363AM0700X | PA18061 (CA) |
Practice location
Suite 204
Prince Frederick, MD 20678
Local context
Active NPPES records list 59 providers with medical physician assistant as the primary taxonomy within 25 miles of this practice location's ZIP code, 7 of them within 10 miles.
The same primary taxonomy is listed by 883 in Maryland and 40,084 nationwide.
These are counts from NPPES records, not a ranking or recommendation. Distances are measured between ZIP code centers, not street addresses.
Record history
- Name on record
- Mrs. Kelly Leigh Mack
- Status
- Active
- NPI issued
- Last updated in NPPES
Is this your record? Updates are made through NPPES, the official National Plan and Provider Enumeration System.
NPPES data as of · Source: CMS NPPES
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