Individual
BRIAN MANGENJE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP-BC
Contact information
Practice address
2888 W GRAND BLVD, DETROIT, MI 48202-2612
(313) 875-4200
(313) 875-5611
Mailing address
31251 BRODERICK DR, CHESTERFIELD, MI 48051-1806
(248) 413-5013
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704278568
MI
Other
Enumeration date
02/05/2022
Last updated
04/13/2026
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