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NPI Code Detail

MEDICARE: MS. MARTI MANKO FNP-C

MEDICARE:  MS. MARTI  MANKO  FNP-C
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
1363LF0000XFamily Nurse PractitionerAP11106AZ

General Provider Information

NPI Number : 1497259725
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MARTI MANKO FNP-C
Provider Business Mailing Address
First Line : 3003 N CENTRAL AVE STE 400
Second Line :
City : PHOENIX
State : AZ
Zip : 85012-2929
Country : US
Telephone Number : 602-685-6000
Fax Number : 602-302-7925
Provider Business Practice Location Address
First Line : 3540 E BASELINE RD STE 150
Second Line :
City : PHOENIX
State : AZ
Zip : 85042-9630
Country : US
Telephone Number : 602-685-6000
Fax Number : 602-243-5390
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2018
Last Update Date : 10/27/2025

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Directions to “ MS. MARTI MANKO FNP-C” Practice Location

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