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General NPI Number Information
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NPI Number | 1295394526
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Entity Type | Individual
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Provider Name | ELISE MCMANAMAN NP
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Gender | Female
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Dates
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Enumeration Date | 06/11/2019
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Last Update Date | 05/21/2024
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Provider Practice Location Address
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Address Line | 3005 PEACHTREE RD NE STE 100
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City | ATLANTA
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State | GA
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Zip | 30305-2214
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Country | US
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Telephone | 470-765-6347
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Fax |
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Provider Business Mailing Address
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Address Line | 333 S DESPLAINES ST STE 201
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City | CHICAGO
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State | IL
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Zip | 60661-5514
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | APRN11019477
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | RN1031565
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License Number State | DC
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Taxonomy #3
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 0024177602
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | RN319751
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License Number State | GA
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Taxonomy #5
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 421651
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License Number State | NY
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Taxonomy #6
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | R232320
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License Number State | MD
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