MEDICARE: RACHEL AMBER MANNING FNP

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	363LF0000X	Family Nurse Practitioner	20260000531	MO

General Provider Information

NPI Number	:	1699608141
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL AMBER MANNING FNP

Provider Business Mailing Address
First Line	:	419 TRINITY RDG
Second Line	:
City	:	PEVELY
State	:	MO
Zip	:	63070-1652
Country	:	US
Telephone Number	:	314-791-2209
Fax Number	:

Provider Business Practice Location Address
First Line	:	4101 4401 MERAMEC BOTTOM RD
Second Line	:	UNIT G
City	:	ST LOUIS
State	:	MO
Zip	:	63129
Country	:	US
Telephone Number	:	314-564-9382
Fax Number	:

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

Provider Enumeration Date	:	06/04/2026
Last Update Date	:	06/04/2026

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