Individual provider · NPI-1
Jennifer Mangold, CRNP, FNP-BC
Clinical Nurse Specialist, Family Health · Wilmington, DE
NPI number1508008319
StatusActive
Last updated in NPPESDec 29, 2021
Details
- NPI
- 1508008319
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Jennifer Mangold
- Credential
- CRNP, FNP-BC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 26, 2009
- Certification date
- Dec 29, 2021
- Last updated
- Dec 29, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 364SF0001X | Clinical Nurse Specialist, Family Health | LG-0011856 | DE | Yes |
| 364SF0001X | Clinical Nurse Specialist, Family Health | SP10248 | PA |
Practice location
1600 Kirkwood HwyWilmington, DE 19805-4918
Phone 302-633-5384 · Fax 302-633-5384
Mailing address
1300 Douglas CirKey West, FL 33040-4536
Phone 305-293-4862
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.