Provider Demographics
NPI:1851280812
Name:MANGAN, ALEXA R (FNP)
Entity type:Individual
Prefix:
First Name:ALEXA
Middle Name:R
Last Name:MANGAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 WESTMINSTER DR
Mailing Address - Street 2:
Mailing Address - City:COLTS NECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07722-1451
Mailing Address - Country:US
Mailing Address - Phone:973-747-9744
Mailing Address - Fax:
Practice Address - Street 1:3626 ROUTE 1
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-5922
Practice Address - Country:US
Practice Address - Phone:609-945-7373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-02
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ15358200363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner