Individual
MS. TAMARA LITQUINNIE MANGUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
8406 SIX FORKS RD STE 104, RALEIGH, NC 27615-3075
(855) 675-4144
(617) 807-0958
Mailing address
8406 SIX FORKS RD STE 104, RALEIGH, NC 27615-3075
(855) 675-4144
(617) 807-0958
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
5010004
NC
Other
Enumeration date
10/12/2017
Last updated
01/06/2026
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