Individual
MS. CONSTANCE J MANGIAMELE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
190 SAILSTAR DR. NW, CASS LAKE, MN 56633
(218) 335-4500
Mailing address
1012 MAPLE RIDGE CT NW, BEMIDJI, MN 56601-8020
(218) 766-5247
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R149441-1
MN
363L00000X
Nurse Practitioner
R1494411
MN
363LF0000X
Family Nurse Practitioner
Primary
R1494411
MN
Other
Enumeration date
01/06/2016
Last updated
01/10/2020
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