Individual
BEATRICE INNA MANGORNONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
111 MICHIGAN AVE NW, WASHINGTON, DC 20010-2916
(202) 476-5000
Mailing address
111 MICHIGAN AVE NW, WASHINGTON, DC 20010-2916
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NP500004231
DC
363L00000X
Nurse Practitioner
SP025927
PA
363LP2300X
Primary Care Nurse Practitioner
NP500004231
DC
Other
Enumeration date
08/03/2022
Last updated
10/20/2022
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