MEDICARE: MRS. ANUP KANG MANES ANP

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
1	363LA2200X	Adult Health Nurse Practitioner	R201499	MD
2	363L00000X	Nurse Practitioner	0024177516	VA

General Provider Information

NPI Number	:	1134463292
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANUP KANG MANES ANP

Provider Business Mailing Address
First Line	:	65 GERMANTOWN CT STE 300
Second Line	:
City	:	CORDOVA
State	:	TN
Zip	:	38018-4258
Country	:	US
Telephone Number	:	901-737-4665
Fax Number	:	901-328-1355

Provider Business Practice Location Address
First Line	:	8640 SUDLEY RD STE 201
Second Line	:
City	:	MANASSAS
State	:	VA
Zip	:	20110-4404
Country	:	US
Telephone Number	:	703-368-6819
Fax Number	:	703-368-0203

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/15/2012
Last Update Date	:	03/18/2026

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