Provider Demographics
NPI:1134463292
Name:MANES, ANUP KANG (ANP)
Entity Type:Individual
Prefix:MRS
First Name:ANUP
Middle Name:KANG
Last Name:MANES
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 GERMANTOWN CT STE 300
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38018-4258
Mailing Address - Country:US
Mailing Address - Phone:901-737-4665
Mailing Address - Fax:901-328-1355
Practice Address - Street 1:8640 SUDLEY RD STE 201
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-4404
Practice Address - Country:US
Practice Address - Phone:703-368-6819
Practice Address - Fax:703-368-0203
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-15
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR201499363LA2200X
VA0024177516363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health