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General NPI Number Information
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NPI Number | 1639026883
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Entity Type | Individual
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Provider Name | KATHLEEN ROXANNE MANNING AGPCNP-BC
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Gender | Female
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Dates
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Enumeration Date | 03/16/2026
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Last Update Date | 03/20/2026
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Provider Practice Location Address
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Address Line | 6801 AIRPORT BLVD
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City | MOBILE
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State | AL
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Zip | 36608-3709
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Country | US
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Telephone | 251-633-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 7751 BELFORT PKWY STE 120
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City | JACKSONVILLE
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State | FL
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Zip | 32256-6921
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Country | US
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Telephone | 904-372-3943
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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 | 3-002870
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License Number State | AL
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