Mancuso, Peggy J.

Mancuso, Peggy J. is an individual health care provider with primary practice located at 5201 Harry Hines Blvd Wish Tubal Clinic, Dallas TX 75235-7708. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife, which is considered as her primary health care specialty. Mancuso, Peggy J. can be contacted via phone (214) 590-5306.

Contact Information

Primary practice address
5201 Harry Hines Blvd Wish Tubal Clinic Dallas TX 75235-7708
Phone: (214) 590-5306
Fax: (214) 590-2798
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X 445642 Texas

Profile Details

NPI number 1356407514
LBN Legal business name Mancuso, Peggy J.
Credentials Certified Nurse Midwife (CNM)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 29th, 2006
Last updated Jul 20th, 2009 - about 15 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 1356407514 NPPES
Texas MEDICAID 036917501
Texas MEDICAID 036917502

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