Provider Demographics
NPI:1619796992
Name:MANNING, SARA LYNN (PHARMD, BCPS)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:LYNN
Last Name:MANNING
Suffix:
Gender:F
Credentials:PHARMD, BCPS
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:LYNN
Other - Last Name:MAGILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:18880 JORDAN LN
Mailing Address - Street 2:
Mailing Address - City:GRANGER
Mailing Address - State:IA
Mailing Address - Zip Code:50109-5514
Mailing Address - Country:US
Mailing Address - Phone:515-205-0405
Mailing Address - Fax:
Practice Address - Street 1:11333 AURORA AVE
Practice Address - Street 2:
Practice Address - City:URBANDALE
Practice Address - State:IA
Practice Address - Zip Code:50322-7908
Practice Address - Country:US
Practice Address - Phone:515-557-3120
Practice Address - Fax:515-557-3125
Is Sole Proprietor?:No
Enumeration Date:2024-10-04
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA23273183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist