Individual
CHERYL MANIAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
11115 W. HWY. 24, UNIT 2C, DIVIDE, CO 80814-8081
(719) 687-6416
(719) 687-6416
Mailing address
PO BOX 928, DIVIDE, CO 80814-0928
(719) 687-6416
(719) 687-6501
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
168066
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04540548
—
CO
Enumeration date
12/19/2017
Last updated
12/19/2017
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