Provider Demographics
NPI:1730768375
Name:MANNING, PAMELA (RN)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:MANNING
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:
Other - Last Name:HOOVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:979 S PACKINGHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34232-2898
Mailing Address - Country:US
Mailing Address - Phone:941-702-6071
Mailing Address - Fax:
Practice Address - Street 1:979 S PACKINGHOUSE RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34232-2898
Practice Address - Country:US
Practice Address - Phone:941-702-6071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-02
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9200383163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
9419280936OtherPHONE