Individual
MRS. ELIZABETH MANGANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
5875 BREMO RD STE 209, RICHMOND, VA 23226-1934
(804) 287-7804
Mailing address
5875 BREMO RD, SOUTH MEDICAL OFFICE BUILDING SUITE 209, RICHMOND, VA 23226-1934
(804) 287-7804
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
0001249704
VA
363LF0000X
Family Nurse Practitioner
Primary
0024176480
VA
Other
Enumeration date
08/01/2018
Last updated
05/08/2020
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