# JULIA MANGAN, FNP, FAMILY PRACTICE CLINIC P.C

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699787168
- **Authorized official:** MRS. JULIA B MANGAN FNP (OWNER)
- **Authorized official phone:** (208) 664-8818

## Contact information

- **Practice address:** 1112 W IRONWOOD DR, COEUR D ALENE, ID 83814-2474
- **Practice address phone:** (208) 664-8818
- **Practice address fax:** (208) 664-4427
- **Mailing address:** 1112 W IRONWOOD DR, COEUR D ALENE, ID 83814-2474
- **Mailing address phone:** (208) 664-8818
- **Mailing address fax:** (208) 664-4427

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | NP334A | ID | Yes |

## Other

- **Enumeration date:** 08/13/2006
- **Last updated:** 05/28/2013