Nakietta Nakiese Mack, LVN
Individual provider Active NPI Licensed Vocational Nurse · Merced, CA
NPI 1154036168 · NPPES record last updated Jun 29, 2023
Key facts
- NPI
- 1154036168
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Vocational Nurse 164X00000X
- License
- 685332 (CA)
- Practice address
- 1343 W Main St Ste a&B
Merced, CA 95340-4438 - Phone
- (818) 206-0360
- NPI assigned
- Jan 16, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 685332 | CA | MD | Licensed Vocational Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aegis Treatment Centers, LLC | Past |
Accepting new patients | |
| Aegis Treatment Centers, LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Vocational Nurse | 164X00000X | 685332 | CA | Yes |
Addresses
Primary practice location
1343 W Main St Ste a&B
Merced, CA 95340-4438
Mailing address
1343 W Main St Ste a&B
Merced, CA 95340-4438
Other providers in Merced, CA
- Christina Han-Souksavong Ma
- Ashley Machado
- Lilia Guerra Macias
- Mia Macias
- Maciej G. Ossowski, M.D., Inc.
- Meysam Madani
- Deborah Ann Maddox
- David Madero
- Madhu K. Kris M.D.
- Madhu K. Kris, M.D., Inc.
All providers in Merced, CA · Licensed Vocational Nurse in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 29, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.