Individual
DEBRA A MANDENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3089 E LONG LAKE RD, TRAVERSE CITY, MI 49684-8582
(231) 929-3646
Mailing address
3089 E LONG LAKE RD, TRAVERSE CITY, MI 49684-8582
(231) 929-3646
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
4704177751
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1043802
—
MI
Enumeration date
06/01/2007
Last updated
07/08/2007
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