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NPI Code Detail

MEDICARE: JENNA NICOLE MANNING NP-C

MEDICARE:   JENNA NICOLE  MANNING  NP-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 PractitionerAP9614AZ

General Provider Information

NPI Number : 1982156352
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNA NICOLE MANNING NP-C
Provider Business Mailing Address
First Line : 10249 W THUNDERBIRD BLVD
Second Line :
City : SUN CITY
State : AZ
Zip : 85351-3113
Country : US
Telephone Number : 623-322-5900
Fax Number :
Provider Business Practice Location Address
First Line : 10249 W THUNDERBIRD BLVD
Second Line : SUITE 300
City : SUN CITY
State : AZ
Zip : 85351-3113
Country : US
Telephone Number : 623-322-5900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2016
Last Update Date : 03/31/2019

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Directions to “ JENNA NICOLE MANNING NP-C” Practice Location

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