Individual
MARY A MANDZIARA
Active
Individual
MARY A MANDZIARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
4704131950
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0866737
BCBSM PIN
MI
05
—
4327582
—
MA
01
—
4704131950
MICHIGAN LICENSE
MI
Enumeration date
10/04/2006
Last updated
10/24/2014
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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