IndividualActive
Antonia Mack, LPN
NPI 1124694088 · Licensed Practical Nurse · Hollywood, SC
Provider details
- NPI number
- 1124694088
- Entity type
- Individual
- Primary specialty
- Licensed Practical NurseNursing Service Providers
- Credential
- LPN
- Sex
- Female
- Sole proprietor
- Yes
- License
- 52017 (SC)
Specialties & taxonomies
Nursing Service Providers
Practice location
6720 Hollytree Dr
Hollywood, SC 29449-6919
Phone: (843) 860-2615
Approximate (ZIP-level) locationGet directions
Mailing address
6720 Hollytree Dr
Hollywood, SC 29449-6919
Registry dates
- Enumerated
- 2021-06-01
- Last updated
- 2021-06-02
- Certified
- 2021-06-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.