Healthcare Provider Details

I. General information

NPI: 1952238206
Provider Name (Legal Business Name): CRISTIANA MANGEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2026
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1315 S BROADWAY ST
NEW ULM MN
56073-3474
US

IV. Provider business mailing address

26423 260TH AVE
SLEEPY EYE MN
56085-4196
US

V. Phone/Fax

Practice location:
  • Phone: 507-359-8700
  • Fax:
Mailing address:
  • Phone: 507-227-8427
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number105036
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: