NICOLE MANNING


Address: 475 Yellowstone Ave, Ste E, Pocatello, ID 83201-4528
Phone: 2082320021

NICOLE MANNING (NPI# 1265441547) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1265441547
Entity Type Individual
Full Name NICOLE MANNING
Credential PA
Practice Address 475 Yellowstone Ave
Ste E
Pocatello
ID 83201-4528
Mailing Address 1110 Call Creek Dr
Ste 7
Pocatello
ID 83201-3072
Practice Telephone 2082320021
Practice Fax Number 2082320031
Mailing Telephone 2082332032
Mailing Fax Number 2082332175
Enumeration Date 2006-08-05
Last Update Date 2016-06-15
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AM0700X Physician Assistant
Specialization: Medical
PA-307 ID Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
ID REGENCE BS OF IDAHO PROV 000010033582 01
ID BLUE CROSS OF ID PROV # PAIA0 01
ID 805791900 05

Other Providers NICOLE MANNING

NPI Name Taxonomy Address Enumeration
1366090284 Nicole Manning Behavior Technician 225 E 225 Ln S, Rupert, ID 83350-5080 2019-09-04
1457696015 Nicole Kelley Manning Nurse Practitioner 102 Shore Dr, Suite 403, Worcester, MA 01605-3154 2012-12-06

Office Location

Street Address 475 YELLOWSTONE AVE
STE E
City POCATELLO
State ID
Zip Code 83201-4528

Providers in the same location

NPI Name Taxonomy Address Enumeration
1649704248 Mvh Pmhs LLC Counselor 475 Yellowstone Ave, Ste E, Pocatello, ID 83201-4528 2017-04-20
1194063750 Physicians Mental Health Services Clinic/Center 475 Yellowstone Ave, Suite E, Pocatello, ID 83201-4528 2013-01-16
1366756181 Cody Rudd Evans Counselor 475 Yellowstone Ave, Ste E, Pocatello, ID 83201-4528 2010-08-04
1467543595 Bradley W Sutton Dentist 475 Yellowstone Ave, Ste D, Pocatello, ID 83201 2006-09-27
1700997947 Sutton Family Dentistry LLC Dentist 475 Yellowstone Ave, Ste D, Pocatello, ID 83201 2006-08-31
1346251063 Norman Gregory Richardson Optometrist 475 Yellowstone Ave, Suite G, Pocatello, ID 83201-4528 2006-08-10

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1235765330 Timothy Palmer Social Worker 400 S 11th Ave, Ste 204, Pocatello, ID 83201 2020-03-20
1225687759 Hanna Percy Nurse Practitioner 1151 Hospital Way Ste 201, Pocatello, ID 83201 2019-09-07
1659935195 Carol Jane Dillon Counselor 707 North 7th Avenue, Suite D, Pocatello, ID 83201 2019-04-30
1154801595 Mv Pocatello Ent, LLC Otolaryngology 333 N 18th Ave Ste B3, Pocatello, ID 83201 2018-08-15
1306344346 Ruth Anne Patton Social Worker 850 E Young St, Pocatello, ID 83201 2018-01-24
1598289274 Lucas Alexander Bryan Specialist/Technologist 1535 E Terry St, Pocatello, ID 83201 2017-08-03
1205365632 Geno Alan Giovanini Denturist 115 S. 15th Ave. Ste. D, Pocatello, ID 83201 2017-06-08
1518415942 Kelli Fries-geslin Nurse Practitioner 500 South 11 Ave Suite 400, Pocatello, ID 83201 2016-09-14
1346797842 Shailyn Jenkins Specialist/Technologist 665 Warren Ave., Pocatello, ID 83201 2016-09-01
1992258149 Christopher Jared White Social Worker 300 N 7th Ave, Pocatello, ID 83201 2016-07-24
Find all providers in zip 83201

Taxonomy Information

Taxonomy Code 363AM0700X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Medical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1720379597 Lance W Mckay Physician Assistant 1151 Hospital Way, Bld D, Pocatello, ID 83201-5091 2011-04-27
1467602920 Stephanie Theresa Hanson Physician Assistant 11460 N Philbin Rd, Pocatello, ID 83202-5306 2008-09-22
1780867457 Southeast Idaho Gastroenterology, Pllc Physician Assistant 1151 Hospital Way Ste A, Pocatello, ID 83201-5091 2007-12-17
1174711758 Rsm Pa Pllc Physician Assistant 1595 Bannock Hwy, Pocatello, ID 83204 2007-10-09
1760597462 Karen Dickerson Physician Assistant 1352 E Center St, Pocatello, ID 83201-4734 2006-08-20
1124040506 Michael John Doyle Physician Assistant 921 S 8th Ave Stop 8311, Pocatello, ID 83209-0002 2006-07-24
1417909862 Cynthia Ann Bunde Physician Assistant 429 Washington Ave, Pocatello, ID 83201-4520 2006-05-16
1750342952 Kebai Dawn Bills Physician Assistant 1777 E. Clark Suite # 210, Pocatello, ID 83201 2006-03-29
1073513065 Helena M. B. Rizor Physician Assistant 1448 E Center St, Pocatello, ID 83201-4105 2005-07-30
1376946012 Angela G Hatch Physician Assistant 777 Hospital Way, Pocatello, ID 83201-5175 2014-10-08
Find all providers in POCATELLO

Competitor

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City POCATELLO
Zip Code 83201

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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