Mangrum, Heather Nicole

Mangrum, Heather Nicole is an individual health care provider with primary practice located at 125 Crestview Park Dr Ste 2 , Dickson TN 37055-2853. 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. Mangrum, Heather Nicole can be contacted via phone (615) 740-5233.

Contact Information

Primary practice address
125 Crestview Park Dr Ste 2 Dickson TN 37055-2853
Phone: (615) 740-5233
Fax: (615) 740-5226
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 15204 Tennessee

Profile Details

NPI number 1013226026
LBN Legal business name Mangrum, Heather Nicole
Credentials FNP-C
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 26th, 2010
Last updated Apr 9th, 2018 - about 7 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 1013226026 NPPES
Tennessee MEDICAID 1530456

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