Ashlee Mack, AGACNP, PMHNP
Nurse Practitioner in Indianapolis, IN. Individual provider (NPI-1).
NPI number1942811682
StatusActive
Last updated in NPPESOct 8, 2026
Details
- NPI
- 1942811682
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Ashlee Mack
- Credential
- AGACNP, PMHNP
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Aug 16, 2020
- Certification date
- Oct 8, 2026
- Last updated
- Oct 8, 2026
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - NURSE PRACTITIONER
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | 71011610A | IN | Yes |
| 363LA2100X | Nurse Practitioner, Acute Care | 71011610A | IN | |
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | 71011610A | IN | |
| 363LG0600X | Nurse Practitioner, Gerontology | 71011610A | IN |
Practice location
4333 Village Trace CtIndianapolis, IN 46254-6232
Phone 463-222-9605 · Fax 317-342-8372
Mailing address
4333 Village Trace CtIndianapolis, IN 46254-6232
Phone 317-652-9627 · Fax 317-342-8372
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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