Individual
DELICIA BROOKE MANGRUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
110 KITTRELL ST, HOHENWALD, TN 38462-1363
(931) 628-4489
Mailing address
7102 GREGORY CT, FAIRVIEW, TN 37062-8287
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1555
AL
363A00000X
Physician Assistant
Primary
4176
TN
Other
Enumeration date
02/27/2020
Last updated
02/03/2026
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