Mack, Kimberly M
Mack, Kimberly M is an individual health care provider with primary practice located at 300 13Th Ave W Ste 1 , Dickinson ND 58601-4875. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Mack, Kimberly M can be contacted via phone (701) 227-7500.Contact Information
Primary practice address
300 13Th Ave W Ste 1
Dickinson ND 58601-4875
Phone: (701) 227-7500
Fax: (701) 227-7575
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 702-11-15-11 | North Dakota |
Profile Details
| NPI number | 1326336884 |
|---|---|
| LBN Legal business name | Mack, Kimberly M |
| Credentials | MSC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 19th, 2011 |
| Last updated | Apr 7th, 2014 - about 10 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1326336884 | NPPES |
| North Dakota | MEDICAID | 54523 |
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