Individual
MANDY CAROL COULSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1649 LUCERNE ST, MINDEN, NV 89423-4369
(775) 782-1603
Mailing address
5240 DENNING AVE, IONA, ID 83427-5100
(208) 243-3612
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
NV
Other
Enumeration date
09/27/2021
Last updated
09/27/2021
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