MEDICARE: KRISTEN M MANEY NP

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	163W00000X	Registered Nurse	254572	WI
2	363L00000X	Nurse Practitioner	13889	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134814742
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTEN M MANEY NP

Provider Business Mailing Address
First Line	:	PO BOX 735031
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60673-5031
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2801 W KINNICKINNIC RIVER PKWY
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53215-3669
Country	:	US
Telephone Number	:	414-384-5111
Fax Number	:

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

Provider Enumeration Date	:	04/10/2023
Last Update Date	:	05/27/2026

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Directions to “ KRISTEN M MANEY NP” Practice Location

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