Individual
MRS. MERCY B MANGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
2400 MT. ZION PARKWAY, KAISER PERMANENTE SOUTHWOOD MEDICAL CENTER, JONESBORO, GA 30236
(770) 603-3649
(770) 962-2400
Mailing address
3495 PIEDMONT ROAD, NE, NINE PIEDMONT CENTER, ATLANTA, GA 30305
(404) 504-5678
(770) 962-2400
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
RN100057
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
433023341
TRICARE
GA
01
—
500030757
RAILROAD MEDICARE PROV #
GA
05
—
942031013A
—
GA
Enumeration date
05/10/2006
Last updated
05/18/2016
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