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General NPI Number Information
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NPI Number | 1699503367
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Entity Type | Individual
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Provider Name | GERI LYNN MANLEY APRN, PMH-BC, CHC
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Gender | Female
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Dates
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Enumeration Date | 07/24/2024
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Last Update Date | 07/24/2024
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Provider Practice Location Address
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Address Line | 1317 ROUTE 73 STE 200
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City | MOUNT LAUREL
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State | NJ
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Zip | 08054-2202
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Country | US
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Telephone | 856-439-6111
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Fax |
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Provider Business Mailing Address
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Address Line | 4605 ONION CREEK CT # A
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City | ELKTON
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State | FL
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Zip | 32033-2066
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Country | US
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Telephone | 386-748-8129
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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 | 163WA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Registered Nurse
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License Number | 9372465
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN11034150
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License Number State | FL
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