Individual
SHAWN M MANGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
111 S 11TH ST, PHILADELPHIA, PA 19107-4824
(215) 355-8304
(215) 923-0835
Mailing address
4300 BOONE ST, PHILADELPHIA, PA 19128-4901
(856) 296-6552
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
SP010334
PA
Other
Enumeration date
06/29/2009
Last updated
01/04/2018
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