# MR. EDDIE A MANLEY

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1538482773
- **Gender:** Man
- **Credential:** APRN

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | 15072 | TN | — |
| 363L00000X | Nurse Practitioner | 3006470 | KY | Yes |
| 363L00000X | Nurse Practitioner | 5005075 | NC | — |
| 363LF0000X | Family Nurse Practitioner | 3006470 | KY | — |

## Other

- **Enumeration date:** 03/02/2010
- **Last updated:** 04/29/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 15072 | TENNESSE LICENSE NUMBER APRN | TN |
| 01 | — | 3006470 | KY APRN LICENSE NUMBER | KY |
| 01 | — | 5005075 | NC APRN LICENSE NUMBER | NC |
| 05 | — | 7100138050 | — | KY |