Provider Demographics
NPI:1588147268
Name:MANSARAY, ISATU (RN, FNP)
Entity type:Individual
Prefix:
First Name:ISATU
Middle Name:
Last Name:MANSARAY
Suffix:
Gender:F
Credentials:RN, FNP
Other - Prefix:
Other - First Name:ISATU
Other - Middle Name:
Other - Last Name:SAWYERR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5846 WOOLDRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-2402
Mailing Address - Country:US
Mailing Address - Phone:361-994-8979
Mailing Address - Fax:361-994-8966
Practice Address - Street 1:5846 WOOLDRIDGE RD
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-2402
Practice Address - Country:US
Practice Address - Phone:361-994-8979
Practice Address - Fax:361-994-8966
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-10
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP139393363LF0000X
TX766926163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No163WG0000XNursing Service ProvidersRegistered NurseGeneral PracticeGroup - Single Specialty