Individual
NICHOLAS MANGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2450 RIVERSIDE AVE, MINNEAPOLIS, MN 55454-1450
(612) 365-6777
Mailing address
420 DELAWARE ST SE, MINNEAPOLIS, MN 55455-0341
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
2030337
MN
367500000X
Certified Registered Nurse Anesthetist
Primary
2607
MN
Other
Enumeration date
06/25/2021
Last updated
08/24/2021
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