Organization
JULIA MANGAN, FNP, FAMILY PRACTICE CLINIC P.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JULIA B MANGAN FNP (OWNER)
(208) 664-8818
Entity
Organization
Contact information
Practice address
1112 W IRONWOOD DR, COEUR D ALENE, ID 83814-2474
(208) 664-8818
(208) 664-4427
Mailing address
1112 W IRONWOOD DR, COEUR D ALENE, ID 83814-2474
(208) 664-8818
(208) 664-4427
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
NP334A
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
805117600
—
ID
Enumeration date
08/13/2006
Last updated
05/28/2013
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