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General NPI Number Information
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NPI Number | 1972835023
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Entity Type | Individual
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Provider Name | JAYTOYA CHENELLE MANGET RN-BC, FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 01/31/2010
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Last Update Date | 01/20/2015
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Provider Practice Location Address
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Address Line | 111 MICHIGAN AVE NW
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City | WASHINGTON
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State | DC
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Zip | 20010-2916
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Country | US
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Telephone | 410-782-1893
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 37215
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City | BALTIMORE
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State | MD
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Zip | 21297-3215
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Country | US
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Telephone | 410-782-1893
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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 | R188701
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN1023331
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License Number State | DC
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R188701
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License Number State | MD
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Taxonomy #4
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN1023331
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License Number State | DC
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