Individual
SUSAN MANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FP
Contact information
Practice address
101 E WOOD ST, SPARTANBURG, SC 29303-3040
(864) 560-6012
(864) 560-6013
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
RN086518
AZ
363LG0600X
Gerontology Nurse Practitioner
Primary
18325
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
367690
—
AZ
05
—
NP2764
—
SC
Enumeration date
11/21/2005
Last updated
02/06/2018
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