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General NPI Number Information
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NPI Number | 1881781623
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Entity Type | Individual
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Provider Name | BRANDI MANNING PA-C
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Gender | Female
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 02/24/2015
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Provider Practice Location Address
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Address Line | 6572 MIDLAND TRAIL RD
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City | ASHLAND
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State | KY
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Zip | 41102-9286
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Country | US
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Telephone | 606-928-7755
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Fax | 606-928-0052
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Provider Business Mailing Address
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Address Line | PO BOX 1595
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City | ASHLAND
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State | KY
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Zip | 41105-1595
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Country | US
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Telephone | 606-408-5044
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Fax | 606-408-7425
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA546
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License Number State | KY
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