Healthcare Provider Details
I. General information
NPI: 1972433407
Provider Name (Legal Business Name): ALYSON SEGRID MCMANNIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
230 W PATRICK ST
FREDERICK MD
21701-6945
US
IV. Provider business mailing address
237 PHILADELPHIA AVE
WAYNESBORO PA
17268-2617
US
V. Phone/Fax
- Phone: 301-662-0099
- Fax:
- Phone: 240-672-3470
- Fax: 240-672-3470
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 163WP0808X |
| Taxonomy | Psychiatric/Mental Health Registered Nurse |
| License Number | R214499 |
| License Number State | MD |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: