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General NPI Number Information
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NPI Number | 1821986019
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Entity Type | Individual
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Provider Name | MARSHALL JONATHAN MANIPOL FNP-BC
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Gender | Male
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Dates
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Enumeration Date | 06/25/2025
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Last Update Date | 01/14/2026
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Provider Practice Location Address
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Address Line | 1031 LOFTIS BLVD BLDG II
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City | NEWPORT NEWS
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State | VA
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Zip | 23606-2981
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Country | US
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Telephone | 757-736-9810
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Fax |
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Provider Business Mailing Address
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Address Line | 1031 LOFTIS BLVD BLDG II
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City | NEWPORT NEWS
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State | VA
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Zip | 23606-2981
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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 | 163WE0003X
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Taxonomy Name | Emergency Registered Nurse
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License Number | 0001285714
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0024195941
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License Number State | VA
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