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General NPI Number Information
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NPI Number | 1053861146
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Entity Type | Individual
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Provider Name | DEBORAH MANGAN-DANCKWART DNP, RN, APRN, CNS
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Gender | Female
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Dates
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Enumeration Date | 10/12/2016
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Last Update Date | 10/12/2016
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Provider Practice Location Address
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Address Line | 67726 207TH AVE
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City | WABASHA
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State | MN
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Zip | 55981-2196
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Country | US
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Telephone | 507-261-7108
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Fax |
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Provider Business Mailing Address
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Address Line | 67726 207TH AVE
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City | WABASHA
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State | MN
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Zip | 55981-2196
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Country | US
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Telephone | 507-261-7108
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Fax |
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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 | 364SA2200X
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Taxonomy Name | Adult Health Clinical Nurse Specialist
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License Number | R 86423-3
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License Number State | MN
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