Healthcare Provider Details

I. General information

NPI: 1659469211
Provider Name (Legal Business Name): MICHELLE TAYLOR-MCMANUS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

314 EAST PITTSBURGH STREET
GREENSBURG PA
15601
US

IV. Provider business mailing address

161 WASHINGTON STREET EIGHT TOWER BRIDGE, SUITE 1400
CONSHOHOCKEN PA
19428
US

V. Phone/Fax

Practice location:
  • Phone: 866-825-3227
  • Fax: 484-351-3800
Mailing address:
  • Phone: 484-351-3200
  • Fax: 484-351-3800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP008383
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: