Individual
SARAH ANN MANGHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5000 HENNESSY BLVD, BATON ROUGE, LA 70808-4375
(225) 757-0552
(225) 763-9997
Mailing address
8230 SUMMA AVE STE C, BATON ROUGE, LA 70809-3465
(225) 757-0552
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.200760
LA
363AS0400X
Surgical Physician Assistant
PA.200760
LA
Other
Enumeration date
09/17/2014
Last updated
09/17/2014
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