Healthcare Provider Details

I. General information

NPI: 1972651230
Provider Name (Legal Business Name): CHRIS MANICK FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2007
Last Update Date: 09/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

68 SWEETEN CREEK RD
ASHEVILLE NC
28803-2318
US

IV. Provider business mailing address

68 SWEETEN CREEK RD
ASHEVILLE NC
28803-2318
US

V. Phone/Fax

Practice location:
  • Phone: 828-274-2400
  • Fax: 828-277-4808
Mailing address:
  • Phone: 828-274-2400
  • Fax: 828-277-4808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number005002507
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: