Provider Demographics
NPI:1528739398
Name:MANLEY, ELIZABETH GAY (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:GAY
Last Name:MANLEY
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Gender:F
Credentials:NURSE PRACTITIONER
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Mailing Address - Street 1:58383 29 PALMS HWY STE 100
Mailing Address - Street 2:
Mailing Address - City:YUCCA VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92284-5891
Mailing Address - Country:US
Mailing Address - Phone:760-228-5864
Mailing Address - Fax:760-365-9184
Practice Address - Street 1:58383 29 PALMS HWY STE 100
Practice Address - Street 2:
Practice Address - City:YUCCA VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92284-5891
Practice Address - Country:US
Practice Address - Phone:760-228-5864
Practice Address - Fax:760-365-9184
Is Sole Proprietor?:No
Enumeration Date:2021-09-22
Last Update Date:2021-09-22
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Provider Licenses
StateLicense IDTaxonomies
CA95018260363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology