Mancuello, Mindi Lyn

Mancuello, Mindi Lyn is an individual health care provider with primary practice located at 2025 Glenn Mitchell Dr , Virginia Beach VA 23456. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Medical is her primary health care specialty. Mancuello, Mindi Lyn can be contacted via phone (757) 507-1000.

Contact Information

Primary practice address
2025 Glenn Mitchell Dr Virginia Beach VA 23456
Phone: (757) 507-1000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA9104369 Florida
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 001618 Connecticut
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 0110004770 Virginia

Profile Details

NPI number 1659313336
LBN Legal business name Mancuello, Mindi Lyn
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 10th, 2006
Last updated Feb 18th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659313336 NPPES
Georgia MEDICAID 182517415A
Georgia MEDICAID 2929279-00

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