Provider Demographics
NPI:1255415733
Name:MANGIAMELI, JOSEPH JR (RN)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:
Last Name:MANGIAMELI
Suffix:JR
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14705 MANDERSON PLZ
Mailing Address - Street 2:SUITE 203
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68116-6269
Mailing Address - Country:US
Mailing Address - Phone:402-934-9762
Mailing Address - Fax:402-717-8115
Practice Address - Street 1:14705 MANDERSON PLZ
Practice Address - Street 2:SUITE 203
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68116-6269
Practice Address - Country:US
Practice Address - Phone:402-934-9762
Practice Address - Fax:402-717-8115
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE60585163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency