Individual
DR. JEAN MARIE MANCINI
Active
Individual
DR. JEAN MARIE MANCINI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
038379
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010105765
VA MEDICAID
—
05
—
3896190
—
TN
01
—
4091342
BCTN
—
Enumeration date
07/01/2005
Last updated
06/11/2014
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