Individual
DR. STEPHANIE C MANGINELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
303 MED TECH PKWY, SUITE 150, JOHNSON CITY, TN 37604-2364
(423) 282-8070
(423) 794-1826
Mailing address
PO BOX 632476, CINCINNATI, OH 45263-2476
(423) 282-8070
(423) 794-1826
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD0000025987
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3122084
BLUE CROSS BLUE SHEILD
TN
05
—
3830484
—
TN
05
—
3830487
—
TN
01
—
5470176
AETNA
TN
Enumeration date
11/17/2005
Last updated
02/19/2025
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