Healthcare Provider Details

I. General information

NPI: 1760347991
Provider Name (Legal Business Name): AZINA MANNING
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5426 N 90TH ST
OMAHA NE
68134-1804
US

IV. Provider business mailing address

2508 BRISTOL ST
OMAHA NE
68111-3221
US

V. Phone/Fax

Practice location:
  • Phone: 402-415-8609
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: