Individual
MISTIE SUE MANNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
1551 RENAISSANCE TOWNE DR STE 370, BOUNTIFUL, UT 84010-7675
(801) 747-7244
Mailing address
1551 RENAISSANCE TOWNE DR STE 370, BOUNTIFUL, UT 84010-7675
(801) 747-7244
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
6926945-4405
UT
Other
Enumeration date
10/23/2020
Last updated
10/23/2020
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