| Brian Mangenje, FNP-BC | |
|
17866 Player Dr, Macomb, MI 48042-1762 | |
| (248) 413-5014 | |
| Not Available |
| Full Name | Brian Mangenje |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner - Family |
| Location | 17866 Player Dr, Macomb, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134873524 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 4704278568 (Michigan) | Primary |
| Entity Name | The Wellness Plan Medical Centers |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1043373244 PECOS PAC ID: 1052380201 Enrollment ID: O20040925000098 |
| Entity Name | Northstar Anesthesia Of Michigan Iii Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1972126209 PECOS PAC ID: 7911325469 Enrollment ID: O20200915001990 |
| Entity Name | Nsa Pain Services Of Michigan Iii, Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1376169524 PECOS PAC ID: 8921428996 Enrollment ID: O20201013000578 |
| Mailing Address | Practice Location Address |
|---|---|
| Brian Mangenje, FNP-BC 17866 Player Dr, Macomb, MI 48042-1762 Ph: (248) 413-5013 | Brian Mangenje, FNP-BC 17866 Player Dr, Macomb, MI 48042-1762 Ph: (248) 413-5014 |
Nicole Marie Trudeau-klimek, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 17900 23 Mile Rd Ste 101, Macomb, MI 48044 Phone: 586-868-9200 Fax: 586-868-9201 | |
Melanie A Rogus, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 48610 Brittany Parc Dr, Macomb, MI 48044 Phone: 586-201-8524 | |
Mrs. Danielle Holly Quinn, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 45441 Heydenreich Rd, Macomb, MI 48044 Phone: 862-268-6005 | |
Alyssa Iannello, NP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 46806 Edgewater Dr, Macomb, MI 48044 Phone: 248-259-7109 | |
Khaled Awwad, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 52129 Monaco Dr, Macomb, MI 48042 Phone: 586-596-5441 | |
Mrs. Praisy Jacob, FNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 50861 Nesting Ridge Dr, Macomb, MI 48044 Phone: 586-764-9892 | |
Christina Leigh, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 21844 23 Mile Rd, Macomb, MI 48042 Phone: 586-598-8115 Fax: 586-789-7426 |