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General NPI Number Information
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NPI Number | 1558979682
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Entity Type | Individual
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Provider Name | MAYA A MANJARREZ APRN
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Gender | Female
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Dates
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Enumeration Date | 07/15/2020
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Last Update Date | 02/26/2025
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Provider Practice Location Address
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Address Line | 233 N 48TH ST STE K
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City | LINCOLN
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State | NE
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Zip | 68504-3512
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Country | US
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Telephone | 402-831-3652
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Fax | 877-550-2086
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Provider Business Mailing Address
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Address Line | 102 WOODMONT BLVD STE 600
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City | NASHVILLE
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State | TN
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Zip | 37205-5250
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 113216
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License Number State | NE
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