Provider Demographics
NPI:1033110101
Name:MANNING, JULIA ANN (CNP)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:ANN
Last Name:MANNING
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 73627
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77273-3627
Mailing Address - Country:US
Mailing Address - Phone:281-444-3278
Mailing Address - Fax:832-249-3861
Practice Address - Street 1:17350 ST. LUKES WAY
Practice Address - Street 2:SUITE 400
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77384-4167
Practice Address - Country:US
Practice Address - Phone:281-444-3278
Practice Address - Fax:832-249-3861
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX550978363LA2100X
TXAP017847363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX154851302Medicaid
TX154851302Medicaid