Provider Demographics
NPI:1477216174
Name:MANIS, CHRISTINA (FNP)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:MANIS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5150 MAE ANNE AVE STE 405
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89523-1859
Mailing Address - Country:US
Mailing Address - Phone:916-532-6305
Mailing Address - Fax:
Practice Address - Street 1:5150 MAE ANNE AVE STE 405
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89523-1859
Practice Address - Country:US
Practice Address - Phone:916-532-6305
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-19
Last Update Date:2023-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95018197363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA95018197OtherBOARD OF NURSING