Provider Demographics
NPI:1376506147
Name:MANION, MARION W II (CRNA)
Entity Type:Individual
Prefix:MR
First Name:MARION
Middle Name:W
Last Name:MANION
Suffix:II
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5507 SATINWOOD CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-8021
Mailing Address - Country:US
Mailing Address - Phone:573-845-3027
Mailing Address - Fax:
Practice Address - Street 1:5507 SATINWOOD CT
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-8021
Practice Address - Country:US
Practice Address - Phone:785-845-3027
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS13-78804-072163W00000X
KS55477367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200369190AMedicaid
KS200369190LMedicaid
KS146095OtherBCBS KS GROUP 110017
KS145265Medicare ID - Type Unspecified
KS200369190AMedicaid