Individual
HEATHER NICOLE MANGRUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
125 CRESTVIEW PARK DR STE 2, DICKSON, TN 37055-2853
(615) 740-5233
(615) 740-5226
Mailing address
125 CRESTVIEW PARK DR STE 2, DICKSON, TN 37055-2853
(615) 740-5233
(615) 740-5226
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
15204
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1530456
—
TN
Enumeration date
09/26/2010
Last updated
04/09/2018
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