MEDICARE: DR. VANESSA LEE MANN DNP, FNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	4704308880	MI

General Provider Information

NPI Number	:	1609133065
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VANESSA LEE MANN DNP, FNP-BC

Provider Business Mailing Address
First Line	:	PO BOX 30161
Second Line	:
City	:	LANSING
State	:	MI
Zip	:	48909-7661
Country	:	US
Telephone Number	:	517-887-4302
Fax Number	:	517-887-4437

Provider Business Practice Location Address
First Line	:	101 W TOWNSEND RD
Second Line	:
City	:	SAINT JOHNS
State	:	MI
Zip	:	48879-9200
Country	:	US
Telephone Number	:	989-403-6022
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/23/2012
Last Update Date	:	05/20/2026

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