Individual
ALPHENA VENECIE DYER-MANTACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN, APRN, FNP-C
Contact information
Practice address
305 TYNDALL WAY, PERRY, GA 31069-9819
(478) 919-1042
Mailing address
305 TYNDALL WAY, PERRY, GA 31069-9819
(478) 919-1042
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APRN-NP285710
GA
Other
Enumeration date
04/28/2026
Last updated
04/28/2026
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