Individual
MANDY MANSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1500 COOPER ST, FORT WORTH, TX 76104-2710
(682) 885-4007
(682) 885-4004
Mailing address
PO BOX 733784, DALLAS, TX 75373-3784
(682) 885-1855
(682) 885-1396
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
712565
TX
363LP0200X
Pediatric Nurse Practitioner
AP126904
TX
363LP2300X
Primary Care Nurse Practitioner
AP126904
TX
Other
Enumeration date
02/09/2015
Last updated
05/14/2024
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