Individual
MS. JESSICA JANE MANGES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
202 LAKE MIRIAM DR, S-1, LAKELAND, FL 33813-2180
(863) 647-2333
(863) 393-1995
Mailing address
202 LAKE MIRIAM DR, S-1, LAKELAND, FL 33813-2180
(863) 647-2333
(863) 393-1995
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
ARNP9254601
FL
Other
Enumeration date
12/14/2011
Last updated
12/14/2011
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