DIOSAN MANGUBAT POWELL

SOUTHAVEN, MS
NPI1275086902
Former NameDIOSAN MANGUBAT AGAGDAN
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LP2300X Nurse Practitioner, Primary Care
(Licence: TN  21474)
Enumeration Date2016-07-29
Last Update Date2018-12-26
Business Address
Mrs. DIOSAN MANGUBAT POWELL FNP
346 STATELINE RD W
SOUTHAVEN, MS 38671-1610
Phone number: 662-510-5353
Mailing Address
Mrs. DIOSAN MANGUBAT POWELL FNP
5248 GARNER LN
SOUTHAVEN, MS 38672-6016
Phone number: 615-585-0469
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