Individual
JENNIFER LIZABETH MANGANELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
175 MERCADO ST STE 131, DURANGO, CO 81301-7318
(970) 382-2000
(970) 382-2069
Mailing address
PO BOX 844088, DALLAS, TX 75284-4088
(505) 609-2258
(505) 609-2259
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
APN.0993958-NP
CO
363LA2100X
Acute Care Nurse Practitioner
Primary
CNP-01904
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000156015
—
CO
Enumeration date
12/16/2011
Last updated
04/02/2026
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