Provider Demographics
NPI:1811714629
Name:MANGLONA, KATHERINE MANGLONA
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:MANGLONA
Last Name:MANGLONA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5430
Mailing Address - Street 2:
Mailing Address - City:SAIPAN
Mailing Address - State:MP
Mailing Address - Zip Code:96950-5430
Mailing Address - Country:US
Mailing Address - Phone:670-483-5286
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 5430
Practice Address - Street 2:3719 MANAGAHA PL
Practice Address - City:SAIPAN
Practice Address - State:MP
Practice Address - Zip Code:96950-5430
Practice Address - Country:US
Practice Address - Phone:670-483-5286
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-23
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider