Individual
NITISH JASMINE MANNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
534 CARATOKE HWY, MOYOCK, NC 27958
(252) 435-6621
(235) 435-2685
Mailing address
PO BOX 11314, BELFAST, ME 04915-4004
(757) 842-4481
(757) 312-3135
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0116026979
VA
207Q00000X
Family Medicine Physician
Primary
2017-01598
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
I20151207002377
PECOS
VA
Enumeration date
04/09/2014
Last updated
11/23/2020
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