Individual provider · Type 1 NPI
Mamie Mukundi Mandela, NURSE PRACTITIONER
Primary Care Nurse Practitioner · Carson, CA
NPI number
1831661370
Active
Practice location
1413 E 218th St
Carson, CA 90745-2402
Fax (310) 518-2585
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner | 363L00000X | 95010871 (CA) |
| Primary Care Nurse Practitioner Primary | 363LP2300X | 95010871 (CA) |
Primary Care Nurse Practitioner: Definition to come...
Other primary care nurse practitioner providers in Carson
About NPI 1831661370
Mamie Mukundi Mandela, NURSE PRACTITIONER's National Provider Identifier is 1831661370, issued on Dec 21, 2018. The primary taxonomy on file is Primary Care Nurse Practitioner (363LP2300X), and the practice location is in Carson, CA. The record was last updated on Jun 14, 2019.