Doctor Name: | MORGAN ANNE MANNINA |
NPI Number: | 1265623722 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | PA.TEMP.PERMIT |
Business Practice Address: | 500 S 6th St Leesville, LA - 714464442 |
Business Phone Number: | 3372398000 |
Business Fax Number: | 3372398003 |
Mailing Address: | 500 S 6th St, LEESVILLE |
State: | LA |
Postal Code: | 714464442 |
Phone Number: | 3372398000 |
Fax Number: | 3372398003 |
NPI Enumeration Date: | 08/08/2007 |
NPI Last Update Date: | 08/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | PA.TEMP.PERMIT |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |