Healthcare Provider Details

I. General information

NPI: 1093979643
Provider Name (Legal Business Name): CHRISTOPHER M MANJARRES CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2008
Last Update Date: 01/02/2025
Certification Date: 01/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6200 N LA CHOLLA BLVD
TUCSON AZ
85741-3529
US

IV. Provider business mailing address

4700 LAS VEGAS BLVD N BLDG 1300
NELLIS AFB NV
89191-6600
US

V. Phone/Fax

Practice location:
  • Phone: 520-742-9000
  • Fax:
Mailing address:
  • Phone: 702-653-3550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberCRNA000469
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberCRNA1014
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code163WF0300X
TaxonomyFlight Registered Nurse
License NumberRN113754
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: