Provider Demographics
NPI:1346788122
Name:MANNING, ROBERT (FNP-C)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:
Last Name:MANNING
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2618 HEATHERSHIRE LN
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-4081
Mailing Address - Country:US
Mailing Address - Phone:315-222-4098
Mailing Address - Fax:
Practice Address - Street 1:2618 HEATHERSHIRE LN
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-4081
Practice Address - Country:US
Practice Address - Phone:315-222-4098
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-01
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC20783363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily