IndividualActive
Jennifer Mack
NPI 1003368150 · Pediatric Nurse Practitioner · Albuquerque, NM
Provider details
- NPI number
- 1003368150
- Entity type
- Individual
- Primary specialty
- Pediatric Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Sex
- Female
- Sole proprietor
- No
- License
- 85353 (NM)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
5904 Holly Ave Ne
Albuquerque, NM 87113-2472
Phone: (505) 298-2505
Fax: (505) 298-2985
Approximate (ZIP-level) locationGet directions
Mailing address
9201 Montgomery Blvd Ne Ste 201
Albuquerque, NM 87111-2467
Additional practice locations (1)
- 9201 Montgomery Blvd Ne Ste 201Albuquerque, NM 87111-2467Phone: (505) 298-2505Fax: (505) 298-2985
Registry dates
- Enumerated
- 2016-10-25
- Last updated
- 2025-09-15
- Certified
- 2025-09-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.