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General NPI Number Information
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NPI Number | 1548779457
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Entity Type | Individual
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Provider Name | JOHN NICHOLAS MANN NP-C
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Gender | Male
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Dates
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Enumeration Date | 09/22/2017
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Last Update Date | 07/22/2022
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Provider Practice Location Address
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Address Line | 1700 SKYLYN DR
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City | SPARTANBURG
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State | SC
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Zip | 29307-1041
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Country | US
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Telephone | 864-573-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 228 RACHEL EVANS DR
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City | BOILING SPRINGS
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State | SC
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Zip | 29316-8395
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Country | US
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Telephone | 864-612-1042
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 21333
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License Number State | SC
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