Provider Demographics
NPI:1114909066
Name:MANNING, KAREN W (FNP)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:W
Last Name:MANNING
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 S CASCADE DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14141-9275
Mailing Address - Country:US
Mailing Address - Phone:716-592-3600
Mailing Address - Fax:716-592-3613
Practice Address - Street 1:230 S CASCADE DR
Practice Address - Street 2:
Practice Address - City:SPRINGVILLE
Practice Address - State:NY
Practice Address - Zip Code:14141-9275
Practice Address - Country:US
Practice Address - Phone:716-592-3600
Practice Address - Fax:716-592-3613
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2016-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF332545363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0003153OtherGHI
NY02209070Medicaid
NY160993858OtherCHAMPUS
NY0145550001OtherDMERC
NYP00189262OtherRR MEDICARE
NY000560417003OtherBCBS
NY9511885AOAOtherINDEPENDENT HEALTH
NY00026522401OtherUNIVERA
P19714Medicare UPIN
NYCC9652Medicare PIN