Provider Demographics
NPI:1578285359
Name:MANIO, MARIE ANTOINETTE (MSN, APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:ANTOINETTE
Last Name:MANIO
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12016 WORTHWOOD ST
Mailing Address - Street 2:
Mailing Address - City:CROWLEY
Mailing Address - State:TX
Mailing Address - Zip Code:76036-4157
Mailing Address - Country:US
Mailing Address - Phone:214-226-2758
Mailing Address - Fax:
Practice Address - Street 1:4200 SOUTH FWY STE 100
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76115-1407
Practice Address - Country:US
Practice Address - Phone:817-750-7334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-19
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1094038363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily