Mack, Kelly Leigh

Mack, Kelly Leigh is an individual health care provider with primary practice located at 995 N. Prince Frederick Blvd Suite 204, Prince Frederick MD 20678. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Mack, Kelly Leigh can be contacted via phone (410) 535-5855.

Contact Information

Primary practice address
995 N. Prince Frederick Blvd Suite 204 Prince Frederick MD 20678
Phone: (410) 535-5855
Fax: (410) 535-6574
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA18061 California
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA07662 Texas

Profile Details

NPI number 1396813960
LBN Legal business name Mack, Kelly Leigh
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 1st, 2006
Last updated Aug 13th, 2019 - about 6 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.

Request for update

Popular Providers