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NPI Code Detail

MEDICARE: MRS. KAREN A MANNAL CNP

MEDICARE: MRS. KAREN A MANNAL CNP
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 Practitioner95472MA
2363LF0000XFamily Nurse PractitionerCNP-01886NM

General Provider Information

NPI Number : 1568412286
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KAREN A MANNAL CNP
Provider Business Mailing Address
First Line : 4304 CARLISLE BLVD NE
Second Line : FOUR HUMOURS HEALTHCARE
City : ALBUQUERQUE
State : NM
Zip : 87107-4811
Country : US
Telephone Number : 505-888-1075
Fax Number : 505-888-1082
Provider Business Practice Location Address
First Line : 4304 CARLISLE BLVD NE
Second Line : FOUR HUMOURS HEALTHCARE
City : ALBUQUERQUE
State : NM
Zip : 87107-4811
Country : US
Telephone Number : 505-888-1075
Fax Number : 505-888-1082
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2006
Last Update Date : 01/11/2022

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Directions to “ MRS. KAREN A MANNAL CNP” Practice Location

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