Provider Demographics
NPI:1497309223
Name:MANGIN, PATRICIA THOMASON (RN)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:THOMASON
Last Name:MANGIN
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 1:1141 HOSPITAL DR NW
Mailing Address - Street 2:
Mailing Address - City:CORYDON
Mailing Address - State:IN
Mailing Address - Zip Code:47112-1774
Mailing Address - Country:US
Mailing Address - Phone:812-738-8708
Mailing Address - Fax:
Practice Address - Street 1:1141 HOSPITAL DR NW
Practice Address - Street 2:
Practice Address - City:CORYDON
Practice Address - State:IN
Practice Address - Zip Code:47112-1774
Practice Address - Country:US
Practice Address - Phone:812-738-8708
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-30
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28183425A174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator