Mangum, Dametra

Mangum, Dametra is an individual health care provider with primary practice located at 112 W Peeler Ave , Shaw MS 38773-8710. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Mangum, Dametra can be contacted via phone (662) 754-3301.

Contact Information

Primary practice address
112 W Peeler Ave Shaw MS 38773-8710
Phone: (662) 754-3301
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 905487 Mississippi

Profile Details

NPI number 1740904846
LBN Legal business name Mangum, Dametra
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 3rd, 2022
Last updated Sep 20th, 2023 - about last year

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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