Provider Demographics
NPI:1477121671
Name:MANNING, CHARLES DURIAN (FNP-C)
Entity Type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:DURIAN
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 1:11228 LIMEHURST PL
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28278-6990
Mailing Address - Country:US
Mailing Address - Phone:618-960-1361
Mailing Address - Fax:
Practice Address - Street 1:11228 LIMEHURST PL
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28278-6990
Practice Address - Country:US
Practice Address - Phone:618-960-1361
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-14
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5014575363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily