Provider Demographics
NPI:1669640645
Name:MANNING, SHARON MONIQUE
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:MONIQUE
Last Name:MANNING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 FOXCHASE DR
Mailing Address - Street 2:APT 214
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95123-1121
Mailing Address - Country:US
Mailing Address - Phone:404-431-4485
Mailing Address - Fax:
Practice Address - Street 1:1010 FOXCHASE DR
Practice Address - Street 2:APT 214
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95123-1121
Practice Address - Country:US
Practice Address - Phone:404-431-4485
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-13
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA637034163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse