Provider Demographics
NPI:1275151326
Name:MANNS, ERICA (COMMUNITY HEALTH WOR)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:MANNS
Suffix:
Gender:F
Credentials:COMMUNITY HEALTH WOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2740 KANSAS DR
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68005-4127
Mailing Address - Country:US
Mailing Address - Phone:402-979-4846
Mailing Address - Fax:
Practice Address - Street 1:112 E MISSION AVE
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68005-5023
Practice Address - Country:US
Practice Address - Phone:402-257-1122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-06
Last Update Date:2020-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker