Provider Demographics
NPI:1558517888
Name:MANNING, MINDY LEE ANN (APRN)
Entity Type:Individual
Prefix:
First Name:MINDY
Middle Name:LEE ANN
Last Name:MANNING
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1206 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:KS
Mailing Address - Zip Code:67501-4501
Mailing Address - Country:US
Mailing Address - Phone:620-259-9003
Mailing Address - Fax:808-374-8046
Practice Address - Street 1:1206 N MAIN ST
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:KS
Practice Address - Zip Code:67501-4501
Practice Address - Country:US
Practice Address - Phone:620-259-9003
Practice Address - Fax:808-374-8046
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-18
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS13-98652-041163W00000X
KS53-82913-041363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100098120AMedicaid