Individual
LIZETTE MANGUM-NNAM NJI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4215 GANNON LN, DALLAS, TX 75237-2914
(972) 283-9090
Mailing address
3601 HUTCH DR, PLANO, TX 75074-8965
(781) 475-4523
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1031514
TX
Other
Enumeration date
05/18/2021
Last updated
05/04/2022
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