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Individual

MANERVIA LEE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1058 RIDGEWOOD PL STE G, JACKSON, MS 39211-2002
(601) 809-9222
Mailing address
1058 RIDGEWOOD PL STE G, JACKSON, MS 39211-2002
(601) 809-9222

Taxonomy

Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
865836
MS
163WC0400X
Case Management Registered Nurse
865836
MS
163WH0200X
Home Health Registered Nurse
865836
MS
164W00000X
Licensed Practical Nurse
Primary
326285
MS
171M00000X
Case Manager/Care Coordinator
172V00000X
Community Health Worker
174400000X
Specialist
174H00000X
Health Educator
372600000X
Adult Companion
373H00000X
Day Training/Habilitation Specialist
374U00000X
Home Health Aide
36693
MS
376J00000X
Homemaker
376K00000X
Nurse's Aide
36693
MS

Other

Enumeration date
06/21/2016
Last updated
01/19/2017
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