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ETHAN RAFAEL MANGUM
NPI 1134979495
Student in an Organized Health Care Education/Training Program in Layton, UT

Active since March 26, 2024
1172 W SERAPHIM CT, LAYTON, UT 84041(385) 439-3790 Get Directions Write a Review

NPPES record last updated: March 26, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Ethan Rafael Mangum NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ETHAN RAFAEL MANGUM (NPI 1134979495) is an individual student in an organized health care education/training program in Layton, Utah and active in the NPI registry since March 2024.

NPPES Registry Identity

NPI1134979495
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameETHAN RAFAEL MANGUM
Location Address1172 W SERAPHIM CTLayton, UT 84041-2213
Mailing Address1172 W Seraphim CtLayton, UT 84041-2213 · (385) 439-3790
Phone(385) 439-3790
Sole ProprietorYes
Enumeration DateMarch 26, 2024
NPPES CertifiedMarch 26, 2024
✔ NPI 1134979495 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
1172 W SERAPHIM CT, Layton, UT 84041
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ethan Mangum's NPI number?

The NPI number for Ethan Mangum is 1134979495. It was assigned to this individual provider in the NPPES registry on March 26, 2024.

Where is Ethan Mangum located?

Ethan Mangum practices at 1172 W Seraphim Ct, Layton, UT 84041. The listed phone number is (385) 439-3790.

What is Ethan Mangum's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Ethan Mangum was last updated on March 26, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.