| Mrs Jacqueline S Mangrum, LPN | |
|
3401 N 67th Ave, Phoenix, AZ 85033-4517 | |
| (623) 691-4085 | |
| Not Available |
| Full Name | Mrs Jacqueline S Mangrum |
|---|---|
| Gender | Female |
| Speciality | Licensed Practical Nurse |
| Location | 3401 N 67th Ave, Phoenix, Arizona |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750583886 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 164W00000X | Licensed Practical Nurse | LP014022 (Arizona) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Jacqueline S Mangrum, LPN 3401 N 67th Ave, Phoenix, AZ 85033-4517 Ph: (623) 691-4085 | Mrs Jacqueline S Mangrum, LPN 3401 N 67th Ave, Phoenix, AZ 85033-4517 Ph: (623) 691-4085 |
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Mr. Annette J Lennon, LPN Licensed Practical Nurse Medicare: Not Enrolled in Medicare Practice Location: 4212 N. 16th Street, Pimc, Phoenix, AZ 85016 Phone: 602-263-1200 Fax: 602-263-1631 | |
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