Delicia Brooke Mangrum, PA-C is a
Physician Assistant based in Hohenwald, Tennessee. Delicia Brooke Mangrum is licensed to practice in Tennessee (license number 4176) and her current practice location is
110 Kittrell St, Hohenwald, Tennessee. She can be reached at her office (for appointments etc.) via phone at
(931) 628-4489.
NPI number for Delicia Brooke Mangrum is 1154955235 and her current mailing address is 7102 Gregory Ct, Fairview, Tennessee. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1154955235.
Provider's Profile
| Full Name | Delicia Brooke Mangrum |
|---|
| Gender | Female |
|---|
| Speciality | Physician Assistant |
|---|
| Location | 110 Kittrell St, Hohenwald, Tennessee |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1154955235
- Provider Enumeration Date: 02/27/2020
- Last Update Date: 02/03/2026
Medical Identifiers
Medical identifiers for Delicia Brooke Mangrum such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1154955235 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363A00000X | Physician Assistant | 4176 (Tennessee) | Primary |
| 363A00000X | Physician Assistant | 1555 (Alabama) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Delicia Brooke Mangrum is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Delicia Brooke Mangrum, PA-C
7102 Gregory Ct,
Fairview, TN 37062-8287
Ph: () - | Delicia Brooke Mangrum, PA-C
110 Kittrell St,
Hohenwald, TN 38462-1363
Ph: (931) 628-4489 |
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