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Individual
EMMA KRISTINE MANDOUH
Active
Individual
EMMA KRISTINE MANDOUH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704362447
MI
163WG0000X
General Practice Registered Nurse
Primary
4704362447
MI
363L00000X
Nurse Practitioner
Primary
4704362447
MI
Other
Enumeration date
01/12/2026
Last updated
07/21/2026
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