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Individual
LAURIE MANDEL
Active
Individual
LAURIE MANDEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
COA-NP-02671
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000372969
ANTHEM
OH
05
—
2249758
—
OH
Enumeration date
10/01/2006
Last updated
10/08/2009
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