Provider Demographics
NPI:1265671689
Name:MANGUAL, MARIAN CAROL (RN)
Entity Type:Individual
Prefix:MRS
First Name:MARIAN
Middle Name:CAROL
Last Name:MANGUAL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9251 NEWKIRK DR
Mailing Address - Street 2:
Mailing Address - City:PARMA HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130-4164
Mailing Address - Country:US
Mailing Address - Phone:440-843-8977
Mailing Address - Fax:
Practice Address - Street 1:9251 NEWKIRK DR
Practice Address - Street 2:
Practice Address - City:PARMA HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-4164
Practice Address - Country:US
Practice Address - Phone:440-843-8977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-09
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH216882163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse