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General NPI Number Information
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NPI Number | 1942413117
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Entity Type | Individual
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Provider Name | MANDY JO VENABLE RN
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Gender | Female
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Dates
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Enumeration Date | 05/07/2007
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Last Update Date | 03/13/2026
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Provider Practice Location Address
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Address Line | 1151 LANE 6
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City | POWELL
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State | WY
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Zip | 82435-9717
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Country | US
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Telephone | 307-202-1137
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Fax |
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Provider Business Mailing Address
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Address Line | 3620 49TH AVE SW
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City | OLYMPIA
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State | WA
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Zip | 98512-6604
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Country | US
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Telephone | 307-254-4874
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN00149963
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 22359
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License Number State | WY
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