Provider Demographics
NPI:1235430166
Name:MANUEL, GIGI MICHELLE (ARNP/FNP)
Entity Type:Individual
Prefix:
First Name:GIGI
Middle Name:MICHELLE
Last Name:MANUEL
Suffix:
Gender:F
Credentials:ARNP/FNP
Other - Prefix:
Other - First Name:GIGI
Other - Middle Name:MICHELLE
Other - Last Name:MANUEL-EAST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP/FNP
Mailing Address - Street 1:8001 9TH ST N # 574
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33702-4109
Mailing Address - Country:US
Mailing Address - Phone:727-577-6888
Mailing Address - Fax:
Practice Address - Street 1:8001 9TH ST N
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33702-4109
Practice Address - Country:US
Practice Address - Phone:727-577-6888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-09
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3006870363L00000X, 363LF0000X
IN71003560A363L00000X
FL11014233363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201011780Medicaid
IN201011780Medicaid