Provider Demographics
NPI:1649554841
Name:TOLAND, MANDIE ANN (FNP)
Entity type:Individual
Prefix:
First Name:MANDIE
Middle Name:ANN
Last Name:TOLAND
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 WHITING ST
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77550-3136
Mailing Address - Country:US
Mailing Address - Phone:832-364-7702
Mailing Address - Fax:
Practice Address - Street 1:646 FM 517 RD W
Practice Address - Street 2:
Practice Address - City:DICKINSON
Practice Address - State:TX
Practice Address - Zip Code:77539-3904
Practice Address - Country:US
Practice Address - Phone:281-218-7200
Practice Address - Fax:281-218-7203
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-06
Last Update Date:2016-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX791550363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily