Individual
DR. KRISHNAVENI MANKU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4800 48TH ST, VALLEY, AL 36854-3666
(334) 756-9180
Mailing address
PO BOX 686, WEST POINT, GA 31833-0686
(706) 643-1073
(706) 643-1070
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
00027650
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00027650
STATE LICENSE
AL
Enumeration date
09/21/2006
Last updated
03/07/2023
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