| NPI | 1659840486 |
|---|---|
| Former Name | MAGGIE KING MANKINS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: WV APRN71119-AGPCNP-BC) |
| Enumeration Date | 2018-11-22 |
| Last Update Date | 2022-07-18 |