Provider Demographics
NPI:1184345472
Name:MANGAS, ROBYN LANE (PA-C)
Entity type:Individual
Prefix:
First Name:ROBYN
Middle Name:LANE
Last Name:MANGAS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9185 ROAD P7
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS GROVE
Mailing Address - State:OH
Mailing Address - Zip Code:45830-9739
Mailing Address - Country:US
Mailing Address - Phone:567-204-3361
Mailing Address - Fax:
Practice Address - Street 1:15054 E US ROUTE 224
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-9794
Practice Address - Country:US
Practice Address - Phone:419-427-3030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-06
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.007712363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant