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Dametra Mangum, FNP
Family Nurse Practitioner in Shaw, Mississippi
NPI 1740904846

Dametra Mangum is a Family Nurse Practitioner based in Brandon, MS and is specialized in Family. Dametra Mangum practices in Shaw, MS and has the professional credentials of FNP. The NPI Number for Dametra Mangum is 1740904846 and holds a License No. 905487 (Mississippi).

The current practice location address for Dametra Mangum is 112 W Peeler Ave, Shaw, MS and can be reached out via phone at 662-754-3301.

Location: 112 W Peeler Ave, Shaw, MS, 39042-8987
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1740904846
Provider Name
Dametra Mangum
Credential
FNP
Provider Entity Type
Individual
Gender
Female
Address
112 W Peeler Ave, Shaw, MS, 39042-8987
Phone Number
662-754-3301
Fax Number
Provider Enumeration Date
10/03/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
112 W Peeler Ave
City
Shaw
State
Mississippi
Zip
38773-8710
Phone Number
662-754-3301
Fax Number
person
Provider Business Mailing Address Details
Address
112 W Peeler Ave
City
Shaw
State
Mississippi
Zip
38773-8710
Phone Number
662-754-3301
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
905487 (Mississippi)
Definition
Definition to come...
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