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Individual
MANDY LYNNE CORMAN
Active
Individual
MANDY LYNNE CORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA053630
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102772019
—
PA
01
—
703141
MEDICARE
PA
Enumeration date
05/02/2012
Last updated
07/17/2025
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