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General NPI Number Information
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NPI Number | 1831915115
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Entity Type | Individual
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Provider Name | JAMIE MANCHERIL CRNP
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Gender | Female
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Dates
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Enumeration Date | 12/02/2024
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Last Update Date | 03/12/2026
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Provider Practice Location Address
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Address Line | 1155 EAST MTN BLVD
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City | WILKES BARRE
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State | PA
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Zip | 18702-7906
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Country | US
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Telephone | 570-808-7916
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Fax | 570-808-6006
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Provider Business Mailing Address
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Address Line | 100 N ACADEMY AVE
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City | DANVILLE
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State | PA
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Zip | 17822-4903
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Country | US
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Telephone | 570-808-7916
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Fax | 570-808-6006
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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 | 363LX0001X
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Taxonomy Name | Obstetrics & Gynecology Nurse Practitioner
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License Number | SP030037
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License Number State | PA
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