Provider Demographics
NPI:1306528930
Name:MANGANA, JLIINA EARNESTINA (DOULA)
Entity type:Individual
Prefix:
First Name:JLIINA
Middle Name:EARNESTINA
Last Name:MANGANA
Suffix:
Gender:F
Credentials:DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 239
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:RI
Mailing Address - Zip Code:02873-0239
Mailing Address - Country:US
Mailing Address - Phone:401-414-8437
Mailing Address - Fax:
Practice Address - Street 1:332 CANONCHET RD APT 102
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:RI
Practice Address - Zip Code:02873-1023
Practice Address - Country:US
Practice Address - Phone:401-584-2262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-03
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula