person
Mrs. Diosan Mangubat Powell, FNP
Primary Care Nurse Practitioner in Southaven, Mississippi
NPI 1275086902

Diosan Mangubat Powell is a Primary Care Nurse Practitioner based in Southaven, MS and is specialized in Primary Care. Diosan Mangubat Powell practices in Southaven, MS and has the professional credentials of FNP. The NPI Number for Diosan Mangubat Powell is 1275086902 and holds a License No. 21474 (Mississippi).

The current practice location address for Diosan Mangubat Powell is 346 Stateline Rd W, Southaven, MS and can be reached out via phone at 662-510-5353 and via fax at 662-510-0409. You can also correspond with Diosan Mangubat Powell through the mailing address at 5248 GARNER LN, SOUTHAVEN, MS - 38672-6016 (mailing address contact number: 615-585-0469).

Location: 346 Stateline Rd W, Southaven, MS, 38672-6016
person
Provider Profile Details
NPI Number
1275086902
Provider Name
Diosan Mangubat Powell
Credential
FNP
Provider Entity Type
Individual
Gender
Female
Address
346 Stateline Rd W, Southaven, MS, 38672-6016
Phone Number
662-510-5353
Fax Number
662-510-0409
Provider Enumeration Date
07/29/2016
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
08778361 05 MS
institution
Provider Business Practice Location Address Details
Address
346 Stateline Rd W
City
State
Zip
38671-1610
Phone Number
662-510-5353
Fax Number
662-510-0409
person
Provider Business Mailing Address Details
Address
346 Stateline Rd W
City
State
Zip
38671-1610
Phone Number
662-510-5353
Fax Number
662-510-0409
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Primary Care
Taxonomy
License No.
21474 (Tennessee)
Definition
Definition to come...
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