Individual
RUTH ROBERTA MANGINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
7330 N 99TH AVE STE 325, GLENDALE, AZ 85307-3022
(623) 209-1474
(623) 209-1475
Mailing address
3815 E BELL RD STE 2200, PHOENIX, AZ 85032-2139
(602) 633-3838
(602) 633-3845
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
AP3232
AZ
363LA2200X
Adult Health Nurse Practitioner
RN087831
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
403458
—
AZ
01
—
Z204343
MEDICARE
—
Enumeration date
01/05/2009
Last updated
06/28/2019
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