Individual
NICOLE D MANGUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
29680 HIGHWAY 50 E, WEST POINT, MS 39773-5589
(662) 605-0382
Mailing address
29680 HIGHWAY 50 E, WEST POINT, MS 39773-5589
(662) 605-0382
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
MS
Other
Enumeration date
11/16/2020
Last updated
11/16/2020
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