Healthcare Provider Details

I. General information

NPI: 1699227892
Provider Name (Legal Business Name): ASHLEY M MANHART MSN, CDE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2016
Last Update Date: 03/10/2025
Certification Date: 03/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1288 VALLEY VIEW DR
COUNCIL BLUFFS IA
51503-5245
US

IV. Provider business mailing address

800 MERCY DR ATTN: DIABETIC EDUCATION
COUNCIL BLUFFS IA
51503-3128
US

V. Phone/Fax

Practice location:
  • Phone: 402-717-3422
  • Fax: 712-328-8461
Mailing address:
  • Phone: 402-717-3422
  • Fax: 402-717-8916

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number115857
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number134722
License Number StateIA
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA182773
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: