Individual provider · Type 1 NPI

Courtney Mangan, NP

Nurse Practitioner · Fort Wayne, IN

NPI number 1417514480 Active

Practice location

7601 W Jefferson Blvd
Fort Wayne, IN 46804-4133

Call (260) 436-8686 Map

Mailing address

PO Box 2526
Fort Wayne, IN 46801-2526

Specialties and licenses

TaxonomyCodeLicense
Nurse Practitioner Primary 363L00000X28160425A (IN)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1417514480

Courtney Mangan, NP's National Provider Identifier is 1417514480, issued on May 24, 2019. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Fort Wayne, IN. The record was last updated on May 24, 2019.