| NPI | 1275046237 |
|---|---|
| Former Name | KELLI ALEXANDRA MACK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 5892) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: NC 239608) |
| 163WC0200X Registered Nurse, Critical Care Medicine (Licence: PA RN632491) | |
| Enumeration Date | 2017-11-13 |
| Last Update Date | 2026-07-28 |