Individual
NICOLE MANLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
14855 N OUTER 40, CHESTERFIELD, MO 63017-2026
(636) 532-0150
Mailing address
14805 N OUTER 40 RD, SUITE 320, CHESTERFIELD, MO 63017-6060
(888) 811-4677
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
137025
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
427588108
—
MO
Enumeration date
05/23/2006
Last updated
07/17/2017
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