ELIZABETH MANGUM (NPI# 1649625807) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649625807 |
| Entity Type | Individual |
| Full Name | ELIZABETH MANGUM |
| Credential | NP |
| Practice Address |
2727 Hearne Ave Ste 301 Shreveport LA 71103 |
| Mailing Address |
1202 Louisiana Ave Shreveport LA 71101-3910 |
| Practice Telephone | 3186316400 |
| Practice Fax Number | 3186310300 |
| Mailing Telephone | 3182128951 |
| Mailing Fax Number | 3182126752 |
| Enumeration Date | 2016-04-25 |
| Last Update Date | 2018-09-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | RN82332 | LA | Nursing Service Providers |
| Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
AP0881 | LA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1411 Claiborne Ave, Shreveport, LA 711034203 | 3188684421 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346386869 | Elizabeth Mangum | Social Worker | 371 8th St, Brooklyn, NY 11215-3604 | 2007-01-30 |
| Street Address |
2727 HEARNE AVE STE 301 |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972714889 | Sai Konduru | Internal Medicine | 2727 Hearne Ave Ste 301, Shreveport, LA 71103-3918 | 2007-05-24 |
| 1356819312 | Joseph Robert Martin | Nurse Practitioner | 2727 Hearne Ave Ste 301, Shreveport, LA 71103 | 2018-11-07 |
| 1982181301 | Megan K Atkinson | Nurse Practitioner | 2727 Hearne Ave Ste 301, Shreveport, LA 71103-3918 | 2018-07-27 |
| 1285111930 | Chenoa Madere Hakun | Nurse Practitioner | 2727 Hearne Ave Ste 301, Shreveport, LA 71103-3918 | 2018-07-25 |
| 1194234047 | Steven Michael Galbraith | Nurse Practitioner | 2727 Hearne Ave Ste 301, Shreveport, LA 71103 | 2017-09-22 |
| 1770012478 | Richard Zachary Choate | Nurse Practitioner | 2727 Hearne Ave Ste 301, Shreveport, LA 71103-3918 | 2017-06-06 |
| 1578827234 | Abdul Latif Bikak | Internal Medicine | 2727 Hearne Ave Ste 301, Shreveport, LA 71103 | 2012-06-27 |
| 1346503307 | Boshra F Louka | Internal Medicine | 2727 Hearne Ave Ste 301, Shreveport, LA 71103 | 2012-06-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083124887 | Elizabeth Ponder | Case Manager/Care Coordinator | 404 Hearne Avenue, Shreveport, LA 71103 | 2017-10-05 |
| 1245648393 | Madiha Tariq | General Acute Care Hospital | Rheumatology Clinic, 1501 Kings Hwy, Sheveport, LA 71103 | 2014-07-31 |
| 1659782688 | Jennifer G Smith | Pharmacist | 1725 Claiborne Ave, Shreveport, LA 71103 | 2014-05-13 |
| 1336568823 | Taylor Jieun Jung | Student in an Organized Health Care Education/Training Program | Lsu Health Sciences Center 1501 Kings Highway, Department of Oral & Maxillofacial Surgery Room 530, Shreveport, LA 71103 | 2014-04-10 |
| 1578984746 | Jamie Terrell | Pharmacist | 1625 Claiborne Ave, Shreveport, LA 71103 | 2013-12-13 |
| 1346675188 | Srijan Tandukar | Internal Medicine | 2751 Albert L Bicknell Dr Ste 2b, Shreveport, LA 71103 | 2013-09-12 |
| 1699017681 | Deanna Elise Mossallati | Internal Medicine | 8551 Greenwood Rd, Suite 410, Shreveport, LA 71103 | 2013-03-18 |
| 1346527330 | Tim M Smith | Clinical Exercise Physiologist | 3200 Greenwood Rd., Shreveport, LA 71103 | 2011-11-04 |
| 1144451683 | Second Chance Recovery | Durable Medical Equipment & Medical Supplies | 3816 Linwood, Shreveport, LA 71103 | 2009-07-31 |
| 1093919920 | Neeraj Singh | Internal Medicine | 2751 Albert L Bicknell Dr Fl 4, Shreveport, LA 71103 | 2007-06-13 |
| Find all providers in zip 71103 | ||||
| Taxonomy Code | 363LG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780237701 | Mary Inman | Nurse Practitioner | 1449 E Bert Koun Loop Ste 100, Shreveport, LA 71105-5680 | 2019-07-18 |
| 1255843801 | Jennifer Michelle Middleton | Nurse Practitioner | 7505 Pines Rd Ste 1235, Shreveport, LA 71129-3900 | 2017-11-03 |
| 1619476595 | Carolyne Adhiambo Redding | Nurse Practitioner | 7505 Pines Rd Ste 1235, Shreveport, LA 71129-3900 | 2018-02-06 |
| 1114449071 | Aaron Stigers | Nurse Practitioner | 2551 Greenwood Rd Ste 220, Shreveport, LA 71103-3985 | 2017-07-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063061950 | Jodie Diane Harrison | Nurse Practitioner | 1120 Robert Blvd Ste 200, Slidell, LA 70458-2069 | 2019-09-04 |
| 1376195271 | Michelle Elaine Johnson Orgeron | Nurse Practitioner | 226 Bouverans Cir, Lockport, LA 70374-3114 | 2019-07-10 |
| 1477927689 | Alanna Denise Hebert | Nurse Practitioner | 1366 Mamou Prairie Rd, Basile, LA 70515-3939 | 2015-11-26 |
| 1861645616 | Sonya Renee Pittman | Nurse Practitioner | 4426 S Carrollton Ave, New Orleans, LA 70119 | 2008-10-24 |
| 1699744664 | Northlake Rehab Professionals | Nurse Practitioner | 2101 Robin Ave, Hammond, LA 70403-5772 | 2006-03-14 |
| 1992700272 | Maureen Adrian Poe | Nurse Practitioner | 1204 W Prien Lake Rd, Lake Charles, LA 70601-8371 | 2005-06-14 |
| 1619595634 | Marguerita M Griffin | Nurse Practitioner | 2503 Broadmoor Blvd, Monroe, LA 71201-2987 | 2020-07-07 |
| 1225665417 | Jacob Robert Rickoll | Nurse Practitioner | 1631 Elysian Fields Ave, New Orleans, LA 70117-8208 | 2020-03-26 |
| 1447882162 | Kristen M. Hill | Nurse Practitioner | 2900 Westfork Dr Ste 401, Baton Rouge, LA 70827-0004 | 2020-02-11 |
| 1992366538 | Amy Lynn Paris | Nurse Practitioner | 503 Mcmillan Rd, West Monroe, LA 71291-5327 | 2019-06-25 |
| Find all providers with the same taxonomy | ||||
| City | SHREVEPORT |
| Zip Code | 71103 |
Please comment or provide details below to improve the information on ELIZABETH MANGUM.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.