Individual
ROBIN JUDITH MANGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
551 HIGHLAND DR, ARCO, ID 83213-5003
(208) 252-7655
(208) 527-3430
Mailing address
PO BOX 145, ARCO, ID 83213-0145
(208) 252-7655
(208) 527-3430
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
13232
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13232
IDAHO STATE BOARD OF NURSING
ID
Enumeration date
10/27/2021
Last updated
10/27/2021
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