Active NPI 1912088055 Individual Practitioner Female Practitioner

Vickie Rochelle Mack

Licensed Practical Nurse • Jackson, MS

Professional Overview & Biography Verified Profile Summary

Vickie Mack is a registered healthcare professional specializing in Licensed Practical Nurse in Jackson, MS. Practice services are available at 811 ALVAREDO ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

811 Alvaredo St

Jackson, MS 392045317

Telephone 6013728941

Specialty Benchmarks & Practice Insights

Comparative analytics for Licensed Practical Nurse in Jackson, MS

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 10.5 Yrs

State Avg: 20.0 Yrs

Regional Practice Density

24 Specialists

Practicing in Jackson, MS (263 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Licensed Practical Nurse Primary Specialty

NUCC Taxonomy Code: 164W00000X

State License MS P122165

An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

00770172 (MS)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events

✅

NPI Profile Active July 09, 2007

NPI status registered as active in NPPES database

📍

Updated Practice Location July 09, 2007

Registered at 811 ALVAREDO ST, JACKSON, MS 392045317 (Tel: 6013728941)

📍

Updated Business Mailing Address July 09, 2007

Registered at 811 ALVAREDO ST, JACKSON, MS 392045317 (Tel: 6013728941)

👤

Provider Name / Credentials Updated July 09, 2007

Recorded as VICKIE MACK

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) July 09, 2007

Licensed Practical Nurse (License #P122165 in MS)

🟢

Initial NPI Registration & Enumeration October 17, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1912088055

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: October 17, 2006

Last Update: July 09, 2007

Sole Proprietor: Yes

Update or Correct Profile

Mailing Address

811 Alvaredo St

Jackson, MS 392045317

Phone: 6013728941

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.