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1407536956
JADEKA MOTLEY MANGRUM
GREENSBORO, NC
NPI
1407536956
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: NC 5018483)
Enumeration Date
2023-07-19
Last Update Date
2023-07-20
Business Address
JADEKA MOTLEY MANGRUM PMHNP
700 WALTER REED DR
GREENSBORO, NC 27403-1128
Phone number: 336-210-5641
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Mailing Address
JADEKA MOTLEY MANGRUM PMHNP
700 GLENDALE DR APT H
GREENSBORO, NC 27406-6469
Phone number: 362-105-6413
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