Provider Demographics
NPI:1073811030
Name:MANNING, JULIE R (CPNP)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:R
Last Name:MANNING
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4314 MEDICAL PKWY
Mailing Address - Street 2:STE. 200
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78756-3334
Mailing Address - Country:US
Mailing Address - Phone:512-454-1110
Mailing Address - Fax:512-374-1354
Practice Address - Street 1:4314 MEDICAL PKWY
Practice Address - Street 2:STE. 200
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756-3334
Practice Address - Country:US
Practice Address - Phone:512-454-1110
Practice Address - Fax:512-374-1354
Is Sole Proprietor?:No
Enumeration Date:2011-03-01
Last Update Date:2011-03-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX712262363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics