Provider Demographics
NPI:1164847760
Name:CHIBWE, MANASSEH ANDREA (FNP-BC, MSN, BSN, RN)
Entity Type:Individual
Prefix:
First Name:MANASSEH
Middle Name:ANDREA
Last Name:CHIBWE
Suffix:
Gender:F
Credentials:FNP-BC, MSN, BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 S WHITACRE ST
Mailing Address - Street 2:
Mailing Address - City:YERINGTON
Mailing Address - State:NV
Mailing Address - Zip Code:89447-2561
Mailing Address - Country:US
Mailing Address - Phone:775-463-2301
Mailing Address - Fax:
Practice Address - Street 1:213 S WHITACRE ST
Practice Address - Street 2:
Practice Address - City:YERINGTON
Practice Address - State:NV
Practice Address - Zip Code:89447-2561
Practice Address - Country:US
Practice Address - Phone:775-463-2301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-19
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVTAPRN700970363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily