Natalie Grace Mignano, IDC
Military Health Care Provider, Independent Duty Corpsman in San Diego, CA. Individual provider (NPI-1).
NPI number1235917543
StatusActive
Last updated in NPPESMar 12, 2024
Details
- NPI
- 1235917543
- Entity type
- Individual (NPI-1)
- Name
- Natalie Grace Mignano
- Credential
- IDC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 18, 2023
- Certification date
- Mar 12, 2024
- Last updated
- Mar 12, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1710I1002X | Military Health Care Provider, Independent Duty Corpsman | – | – | Yes |
Practice location
34101 Farenholt Ave Bldg 14San Diego, CA 92134-7000
Phone 785-317-5184
Mailing address
1214 Clark Springs DrKeller, TX 76248-3642
Phone 785-317-5184
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All 1,039 Independent Duty Corpsman providers in San Diego · All 61,118 providers in San Diego
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