Mrs. Jessica Leigh Mack
Nurse Practitioner Critical Care Medicine Nurse Practitioner - Critical Care Medicine
1 Medical Center Blvd
Winston Salem
, North Carolina 27157-0001
Mrs. Jessica Leigh Mack
Nurse Practitioner Critical Care Medicine Nurse Practitioner - Critical Care Medicine
1 Medical Center Blvd
Winston Salem
, North Carolina 27157-0001
(828) 289-9211
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About
Features
Specialties
- Critical Care Medicine
- Nurse Practitioner
- Nurse Practitioner - Critical Care Medicine
Languages spoken
- English
Location
First Address
- Mrs. Jessica Leigh Mack
- 5515 Old Meadow Rd
- Charlotte, NC
- Zip : 28227-2677
- Phone : (828) 289-9211
Second Address
- Mrs. Jessica Leigh Mack
- 1 Medical Center Blvd
- Winston Salem, NC
- Zip : 27157-0001
- Phone : (336) 716-2011
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207RC0200X | Critical Care Medicine | 254774 | NC |
| Y | 363L00000X | Nurse Practitioner | 5012459 | NC |
| N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 5012459 | NC |
National Provider Identifier
| NPI | 1457994097 |
|---|---|
| Provider Name | Mrs. Jessica Leigh Mack |
| First Address | Charlotte, NC 28227-2677 |
| Second Address | Winston Salem, NC 27157-0001 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 27/10/2019 |
| Last Update Date | 29/10/2019 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.