Physician Compare National (NPI:1912144866)

HEALTHCARE PROVIDER: TAMMY ELIZABETH MANGANELLI DNP

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1912144866
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4082760962
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20090917000321
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MANGANELLI
	Individual professional last name
Provider First Name	TAMMY
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2008
	Individual professional's medical school graduation year
Primary Specialty	NURSE PRACTITIONER
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	13260 N 94TH DR
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 102
	Group Practice or individual's line 2 address
City	PEORIA
	Group Practice or individual's city
State	AZ
	Group Practice or individual's state
Zip Code	853814242
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y