IndividualActive
Elizabeth Mangum, NP
NPI 1649625807 · Gerontology Nurse Practitioner · Shreveport, LA
Provider details
- NPI number
- 1649625807
- Entity type
- Individual
- Primary specialty
- Gerontology Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- NP
- Sex
- Female
- Sole proprietor
- No
- License
- AP08881 (LA)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Nursing Service Providers
Practice location
1541 Kings Hwy
Shreveport, LA 71103-4228
Phone: (318) 626-0000
Fax: (318) 629-4833
Approximate (ZIP-level) locationGet directions
Mailing address
1512 W Kirby Pl
Shreveport, LA 71103-3822
Additional practice locations (2)
- 2727 Hearne Ave Ste 301Shreveport, LA 71103Phone: (318) 631-6400Fax: (318) 631-0300
- 1411 Claiborne AveShreveport, LA 71103-4203Phone: (318) 868-4421
Registry dates
- Enumerated
- 2016-04-25
- Last updated
- 2023-02-27
- Certified
- 2023-02-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.