Mack, Kakethia S.
Mack, Kakethia S. is an sole proprietor health care provider with primary practice located at 4124 Bosenberry Way , Ellenwood GA 30294. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Mack, Kakethia S. can be contacted via phone (678) 463-6568.Contact Information
Primary practice address
4124 Bosenberry Way
Ellenwood GA 30294
Phone: (678) 463-6568
Fax: (678) 463-6568
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | RN154797 | Georgia |
Profile Details
| NPI number | 1346748837 |
|---|---|
| LBN Legal business name | Mack, Kakethia S. |
| Credentials | NURSE PRACTITIONER |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 30th, 2018 |
| Last updated | Jul 2nd, 2018 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Popular Providers
-
Dallas, Pamela Nicole
3462 Ashford Loop , Ellenwood GA 30294-3674 -
Hicks, Tennille Morris
179 Cook Dr , Ellenwood GA 30294-2617 -
Lemons, Terrilyn D
4018 Park Place Cir , Ellenwood GA 30294-1500 -
Simmons, Trevino C
256 Essex Pl , Ellenwood GA 30294-4106 -
Deas, Rhonda L.
4677 Tara Woods Dr , Ellenwood GA 30294-2004 -
Earl, Jill Van
3413 Harvest Dr , Gordonville PA 17529-9586 -
Curtis, Siameco
4335 Ivy Run , Ellenwood GA 30294-6521 -
Ford, Maria Montrice
210 Blue Ridge Ct , Ellenwood GA 30294-2972