Individual
ANGELITA MANUEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP
Contact information
Practice address
5444 BARABOO CT, DAVENPORT, IA 52804-4873
(309) 883-1373
Mailing address
5444 BARABOO CT, DAVENPORT, IA 52804-4873
(309) 883-1373
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A157318
IA
363LP2300X
Primary Care Nurse Practitioner
A157318
IA
Other
Enumeration date
12/03/2021
Last updated
12/03/2021
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