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General NPI Number Information
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NPI Number | 1457136848
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Entity Type | Individual
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Provider Name | THOMAS RYAN MANUGUERRA APRN-CNP
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Gender | Male
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Dates
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Enumeration Date | 08/25/2023
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Last Update Date | 11/25/2025
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Provider Practice Location Address
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Address Line | 1200 EVERETT DR # 8NP8305
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City | OKLAHOMA CITY
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State | OK
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Zip | 73104-5047
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Country | US
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Telephone | 405-271-5211
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Fax | 405-271-2945
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Provider Business Mailing Address
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Address Line | 2452 GLEN VALLEY DR
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City | WESTLAKE
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State | OH
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Zip | 44145-4703
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Country | US
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Telephone | 419-239-7585
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 223577
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 363LP0222X
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Taxonomy Name | Critical Care Pediatric Nurse Practitioner
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License Number | APRN.CNP.0034766
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License Number State | OH
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