Individual
MARY C. MANNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
1320 WISCONSIN AVE, RACINE, WI 53403-1978
(262) 687-2363
Mailing address
1320 WISCONSIN AVE, RACINE, WI 53403-1978
(262) 687-2363
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2655-033
WI
Other
Enumeration date
07/25/2006
Last updated
07/08/2007
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