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General NPI Number Information
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NPI Number | 1255575643
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Entity Type | Individual
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Provider Name | MANDY POLLACK APRN
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Gender | Female
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Dates
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Enumeration Date | 04/29/2009
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Last Update Date | 11/24/2025
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Provider Practice Location Address
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Address Line | 1120 N BETTY LN
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City | CLEARWATER
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State | FL
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Zip | 33755-3303
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Country | US
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Telephone | 813-951-0648
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Fax |
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Provider Business Mailing Address
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Address Line | 8913 TOWN AND COUNTRY CIR # 1066
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City | KNOXVILLE
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State | TN
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Zip | 37923-4931
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 53-83725-122
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 9245838
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | ARNP9245838
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 3012712
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License Number State | KY
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