Healthcare Provider Details

I. General information

NPI: 1952014813
Provider Name (Legal Business Name): KATRINA MANNING MSN, CRNP, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2023
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 GAY ST
PHOENIXVILLE PA
19460-3852
US

IV. Provider business mailing address

601 GAY ST
PHOENIXVILLE PA
19460-3852
US

V. Phone/Fax

Practice location:
  • Phone: 610-917-2200
  • Fax: 610-917-2360
Mailing address:
  • Phone: 610-917-2200
  • Fax: 610-917-2360

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN714949
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number0000245856
License Number StateTN
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberSP029845
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: