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NPI Code Detail

MEDICARE: JANET E. MANLEY RN, CPNP

MEDICARE: JANET E. MANLEY RN, CPNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered NurseRN064302GA
2363LP0200XPediatric Nurse PractitionerRN064302 NPGA

General Provider Information

NPI Number : 1063810166
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANET E. MANLEY RN, CPNP
Provider Business Mailing Address
First Line : 116 PIERCE AVE
Second Line :
City : MACON
State : GA
Zip : 31204-2891
Country : US
Telephone Number : 478-751-2825
Fax Number : 478-751-2897
Provider Business Practice Location Address
First Line : 116 PIERCE AVE
Second Line :
City : MACON
State : GA
Zip : 31204-2891
Country : US
Telephone Number : 478-751-2825
Fax Number : 478-751-2897
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2014
Last Update Date : 12/05/2014

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