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NPI Code Detail

MEDICARE: MANUSHKA NOELUS MSN, APRN, FNP - C

MEDICARE: MANUSHKA NOELUS MSN, APRN, 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 Practitioner11010115FL

General Provider Information

NPI Number : 1841893963
Entity Type Code : Individual
Provider Name (Legal Business Name) : MANUSHKA NOELUS MSN, APRN, FNP - C
Provider Business Mailing Address
First Line : 7575 OSCEOLA POLK LINE RD
Second Line :
City : DAVENPORT
State : FL
Zip : 33896-9112
Country : US
Telephone Number : 561-598-3550
Fax Number :
Provider Business Practice Location Address
First Line : 7575 OSCEOLA POLK LINE RD
Second Line :
City : DAVENPORT
State : FL
Zip : 33896-9112
Country : US
Telephone Number : 321-677-0531
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/19/2020
Last Update Date : 04/03/2024

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