| Brian Mangenje, FNP-BC | |
|
2888 W Grand Blvd, Detroit, MI 48202-2612 | |
| (313) 875-4200 | |
| (313) 875-5611 |
| Full Name | Brian Mangenje |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner - Family |
| Location | 2888 W Grand Blvd, Detroit, 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 31251 Broderick Dr, Chesterfield, MI 48051-1806 Ph: (248) 413-5013 | Brian Mangenje, FNP-BC 2888 W Grand Blvd, Detroit, MI 48202-2612 Ph: (313) 875-4200 |
Catherine Ann Wenz, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 16411 Curtis St, Detroit, MI 48235 Phone: 313-838-6822 | |
Mikayla William, NURSE PRACTITIONER Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2799 W Grand Blvd, Detroit, MI 48202 Phone: 313-916-2600 | |
Amber Marroquin, NNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2799 W Grand Blvd, Detroit, MI 48202 Phone: 800-653-6568 | |
Michelle M Wojek, NP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 400 Renaissance Ctr Ste 2600, Detroit, MI 48243 Phone: 888-731-8994 | |
Tiwanna Jeaninne Williams, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 12121 Broadstreet Ave, Detroit, MI 48204 Phone: 313-824-1000 | |
Mrs. Ines Hurley, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3950 Beaubien St, Detroit, MI 48201 Phone: 313-745-5437 | |
Nicole Woznicki, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3901 Chrysler Dr, Detroit, MI 48201 Phone: 313-966-7601 |