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General NPI Number Information
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NPI Number | 1508556499
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Entity Type | Individual
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Provider Name | MARCIA MOURINE MANNING-OKEKE APRN
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Gender | Female
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Dates
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Enumeration Date | 05/12/2023
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Last Update Date | 06/07/2023
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Provider Practice Location Address
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Address Line | 1825 COUNTY SERVICES PKWY SW
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City | MARIETTA
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State | GA
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Zip | 30008-4013
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Country | US
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Telephone | 770-499-4200
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Fax |
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Provider Business Mailing Address
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Address Line | 2451 NORTHMILL LN
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City | DECATUR
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State | GA
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Zip | 30035-3522
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Country | US
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Telephone | 404-319-5876
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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 | 241049
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License Number State | GA
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