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General NPI Number Information
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NPI Number | 1609492941
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Entity Type | Individual
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Provider Name | ROSE MARGARET MANTEL CNP
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Gender | Female
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Dates
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Enumeration Date | 06/23/2020
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Last Update Date | 10/17/2024
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Provider Practice Location Address
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Address Line | 13521 STEELECROFT PKWY STE D
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City | CHARLOTTE
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State | NC
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Zip | 28278-7934
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Country | US
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Telephone | 704-315-5845
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Fax |
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Provider Business Mailing Address
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Address Line | 13521 STEELECROFT PKWY STE D
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City | CHARLOTTE
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State | NC
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Zip | 28278-7934
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Country | US
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Telephone | 704-315-5845
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN.CNP.0026942
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 5015445
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License Number State | NC
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