Doctor Name: | CHRISTINE L MANKO |
NPI Number: | 1073646055 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CRNP |
License Number: | R065595 |
Business Practice Address: | 1838 Greene Tree Rd Suite 225a Pikesville, MD - 212086391 |
Business Phone Number: | 4434710470 |
Business Fax Number: | |
Mailing Address: | 515 Fairmount Ave, Ste 400 TOWSON |
State: | MD |
Postal Code: | 212865466 |
Phone Number: | 4104941324 |
Fax Number: | 4104941361 |
NPI Enumeration Date: | 03/13/2007 |
NPI Last Update Date: | 04/18/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | R065595 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |