Individual provider · Type 1 NPI

Jennifer Mack

Pediatric Nurse Practitioner · Albuquerque, NM

NPI number 1003368150 Active

Practice location

5904 Holly Ave NE
Albuquerque, NM 87113-2472

Call (505) 298-2505 Map

Fax (505) 298-2985

Mailing address

9201 Montgomery Blvd NE Ste 201
Albuquerque, NM 87111-2467

Other practice locations

  • 9201 Montgomery Blvd NE Ste 201, Albuquerque, NM 87111-2467 · (505) 298-2505

Specialties and licenses

TaxonomyCodeLicense
Pediatric Nurse Practitioner Primary 363LP0200X85353 (NM)

Pediatric Nurse Practitioner: Definition to come...

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About NPI 1003368150

Jennifer Mack's National Provider Identifier is 1003368150, issued on Oct 25, 2016. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Albuquerque, NM. The record was last updated on Sep 15, 2025.