Provider Demographics
NPI:1518681824
Name:MANES, SCOTTI (DNP-PC, CPNP)
Entity Type:Individual
Prefix:DR
First Name:SCOTTI
Middle Name:
Last Name:MANES
Suffix:
Gender:F
Credentials:DNP-PC, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 CARR CIR
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63366-3402
Mailing Address - Country:US
Mailing Address - Phone:314-800-7163
Mailing Address - Fax:
Practice Address - Street 1:621 S BALLAS RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63122-5314
Practice Address - Country:US
Practice Address - Phone:314-251-6990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-29
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO202224100363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics