Individual
MRS. MANA Z AGBONGHAE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1901 VETERANS MEMORIAL DR, TEMPLE, TX 76504-7451
(254) 654-8036
Mailing address
10021 BIRCH TREE DR, TEMPLE, TX 76502-5368
(254) 654-8036
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP139197
TX
Other
Enumeration date
11/03/2018
Last updated
11/03/2018
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