Provider Demographics
NPI:1669742961
Name:MANGAS, MEGAN CLEMENS (RN, CRNA)
Entity type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:CLEMENS
Last Name:MANGAS
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Gender:F
Credentials:RN, CRNA
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Mailing Address - Street 1:3200 SYCAMORE CT
Mailing Address - Street 2:STE 1B
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47203-1545
Mailing Address - Country:US
Mailing Address - Phone:812-378-9027
Mailing Address - Fax:812-378-1014
Practice Address - Street 1:3200 SYCAMORE CT
Practice Address - Street 2:STE 1B
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47203-1545
Practice Address - Country:US
Practice Address - Phone:812-378-9027
Practice Address - Fax:812-378-1014
Is Sole Proprietor?:No
Enumeration Date:2012-01-04
Last Update Date:2021-08-06
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Provider Licenses
StateLicense IDTaxonomies
IL209.009298367500000X
IN28262247A367500000X
IL041.353761163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse