NPI | 1538482773 |
---|---|
Professional Name | EDDIE A MANLEY |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 3006470) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 15072) |
363L00000X Nurse Practitioner (Licence: NC 5005075) | |
363LF0000X Nurse Practitioner, Family (Licence: KY 3006470) | |
Enumeration Date | 2010-03-02 |
Last Update Date | 2018-04-29 |