Mangino, Ruth Roberta

Mangino, Ruth Roberta is an individual health care provider with primary practice located at 7330 N 99Th Ave Ste 325 , Glendale AZ 85307-3022. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Mangino, Ruth Roberta can be contacted via phone (623) 209-1474.

Contact Information

Primary practice address
7330 N 99Th Ave Ste 325 Glendale AZ 85307-3022
Phone: (623) 209-1474
Fax: (623) 209-1475
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X RN087831 Arizona
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X AP3232 Arizona

Profile Details

NPI number 1194961664
LBN Legal business name Mangino, Ruth Roberta
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 5th, 2009
Last updated Jun 28th, 2019 - about 6 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 1194961664 NPPES
Arizona MEDICAID 403458
Arizona Other Z204343

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