NPI | 1487175097 |
---|---|
Former Name | ABBY NICOLE MANGILARDI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: KS 48644) |
Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: VA 0002092858) |
Enumeration Date | 2017-07-05 |
Last Update Date | 2018-06-16 |