Individual
MISTY MANUEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
998 S DORSET RD STE 301, TROY, OH 45373-4748
(937) 339-9865
Mailing address
998 S DORSET RD STE 301, TROY, OH 45373-4748
(937) 339-9865
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
APRN.CNP.026127
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
APRN.CNP.026127
APRN LICENSE
OH
Enumeration date
01/02/2020
Last updated
01/02/2020
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