Mangolds, Virginia

Mangolds, Virginia is an individual health care provider with primary practice located at 55 Lake Ave N , Worcester MA 01655-0002. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Mangolds, Virginia can be contacted via phone (508) 421-1400.

Contact Information

Primary practice address
55 Lake Ave N Worcester MA 01655-0002
Phone: (508) 421-1400
Fax: (508) 421-1490
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X RN155115 Massachusetts

Profile Details

NPI number 1922072768
LBN Legal business name Mangolds, Virginia
Credentials Certified Nurse Practitioner (CNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 16th, 2006
Last updated Aug 15th, 2022 - about 3 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 1922072768 NPPES
Massachusetts MEDICAID 110018863A

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