Provider Demographics
NPI:1487013728
Name:MANLEY, AMY MARIE (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:MARIE
Last Name:MANLEY
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7030 CANAL BLVD
Mailing Address - Street 2:FL 2
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70124-3410
Mailing Address - Country:US
Mailing Address - Phone:504-503-6760
Mailing Address - Fax:504-503-6761
Practice Address - Street 1:7030 CANAL BLVD
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70124-3410
Practice Address - Country:US
Practice Address - Phone:504-503-6760
Practice Address - Fax:504-503-6761
Is Sole Proprietor?:No
Enumeration Date:2016-02-15
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA08572363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily