Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
KELLIE MANDYGO
ActiveKELLIE MANDYGO is a Community Health Worker healthcare provider located in SHREVEPORT, Louisiana. NPI 1720520752 is currently active in the NPPES registry. Verify at CMS.
Community Health Worker · SHREVEPORT, LA
Registration Details
- NPI Number
- 1720520752
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Nov 8, 2016 (9.8062171017054 yrs)
- Last Updated
- Jul 24, 2019
Practice Information
- Address
-
3341 YOUREE DRSHREVEPORT, LA, 711052149Browse LA providers · Browse ZIP 71105
- Phone
- 3182194167
- Fax
- 3182194834
- Primary Specialty
-
Community Health Worker
172V00000X
- Additional Specialty
- Community Health Worker
Other Community Health Worker Providers in SHREVEPORT, LA
| Name | Credential | NPI |
|---|---|---|
| MR. ROBERT EARL BLOUNT | N/A | 1528394368 |
| MR. ERIC MARC ERLEWINE | MPT | 1750605622 |
| KRASHANTA BARRETT | PTA | 1043692072 |
| TAMA DEMERY | — | 1477906535 |
| JERELL M. COLEMAN | B.S., ES | 1790232767 |
| EVE SCROGGINS | BA | 1710434766 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.