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General NPI Number Information
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NPI Number | 1013206655
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Entity Type | Individual
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Provider Name | GRACE MANGLET DNP ( PMH-NP-BC)
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Gender | Female
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Dates
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Enumeration Date | 04/05/2011
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Last Update Date | 01/08/2025
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Provider Practice Location Address
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Address Line | 18403 WOODFIELD RD STE D
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City | GAITHERSBURG
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State | MD
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Zip | 20879-4794
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Country | US
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Telephone | 301-250-0404
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Fax | 301-637-7970
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Provider Business Mailing Address
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Address Line | 18403 WOODFIELD RD STE D
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City | GAITHERSBURG
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State | MD
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Zip | 20879-4794
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Country | US
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Telephone | 301-250-0404
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Fax | 301-637-7970
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | F401339
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | R226503
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License Number State | MD
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